Lance Damon Peterson, PHYSICIAN ASSISSTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA291 Issued in MA

Practice address

150 York St
Stoughton, MA 02072-1829

Phone

(339) 237-2629

NPI assigned

Nov 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• New England Sinai Hospital

  • Long Term Care Hospital
  • Stoughton, MA
  • NPI 1780724104
  NPD (past) Authorized official
• Inpatient Consultants of Massachusetts, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1093148926

  Physician Assistant

  NPD (past)
• Quincy Physician Corporation

  • Critical Care Medicine (Anesthesiology) Physician
  • Quincy, MA
  • NPI 1144426503
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1659552610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 VICTORIA RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692433",
            "telephone_number": "617-328-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 YORK ST",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721829",
            "telephone_number": "339-237-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LANCE",
        "middle_name": "DAMON",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISSTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Yvonne Perdue
• Bruno Andrade Pereira
• Perfect Imperfections RX
• Lillian Perkins-Reisdorff
• Christina Perry, DPT
• Jessica N Petrone
• Binsu Philip
• Molly Karensue Piaseczny, LICSW
• Welley Pich
• Donna M Pierce, CRNA

• Physician Assistant in Stoughton, MA
• Providers in Stoughton, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.