Laryn A Peterson, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01031101A Issued in IN

Practice address

8040 Clearvista Pkwy Ste 350
Indianapolis, IN 46256-4673

Phone

(317) 844-7059

Fax

(317) 819-0044

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lpeterson@oa2046.srs-direct.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IEEADA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Otolaryngology Associates, LLC

  • Otolaryngology Physician
  • Indianapolis, IN
  • NPI 1447398839
  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1639236995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 N MERIDIAN ST STE 222",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605350",
            "telephone_number": "317-819-4516",
            "fax_number": "317-819-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CLEARVISTA PKWY STE 350",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564673",
            "telephone_number": "317-844-7059",
            "fax_number": "317-819-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LARYN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01031101A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "040014115",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100226860",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01157080",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LPETERSON@OA2046.SRS-DIRECT.COM",
            "affiliation": "Y",
            "affiliationName": "Otolaryngology Associates, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9002 North Meridian Street",
            "address_2": "Suite 222",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462605350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Peterson
• Erin Kay Peterson, MOT, OTR
• Helen Katie Peterson, DDS
• Jan E Peterson II, MD
• Joanna Sue Peterson, MGW, LCSW
• Madeline Rae Peterson, NP
• Matthew Peterson
• Melanie R Peterson, DMD
• Merritt M Peterson, CAA
• Paul Frederick Peterson, DDS

• Otolaryngology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.