Joseph Roger Peterson, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

55789 Issued in WI

Practice address

400 Water Ave
Hillsboro, WI 54634-9054

Phone

(608) 489-8000

NPI assigned

Oct 10, 2005

Last updated

Apr 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpeterson864860@direct.emplifyhealth.org
• Direct secure messaging: jpeterson864860@direct.gundersenhealth.org

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

• St. Joseph's Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798
  Medicare reassignment NPD
• St. Joseph's Health Services, Inc.

  • Critical Access Hospital
  • Hillsboro, WI
  • NPI 1972591410
  Medicare reassignment NPD
• St. Joseph's Health Services, Inc

  • Rural Health Clinic/Center
  • Wonewoc, WI
  • NPI 1881607463
  NPD
• St. Joseph's Health Services, Inc.

  • Clinic/Center
  • Elroy, WI
  • NPI 1699788273
  NPD
• Ana T Sauceda MD PLLC

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1578897203
  NPD (past)
• Steven a. Davis MD PA

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1043236532
  NPD (past)
• Susan J. Mahler, M.D., P.a.

  • Dermatology Physician
  • Boerne, TX
  • NPI 1376597211
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1679561070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WATER AVE",
            "city": "HILLSBORO",
            "state": "WI",
            "postal_code": "546349054",
            "telephone_number": "608-489-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WATER AVE",
            "city": "HILLSBORO",
            "state": "WI",
            "postal_code": "546349054",
            "telephone_number": "608-489-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOSEPH",
        "middle_name": "ROGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L5092",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "55789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpeterson864860@direct.gundersenhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT MESSAGING",
            "address_1": "400 Water Ave",
            "city": "Hillsboro",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546349054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Padberg, RN
• Kelli L Pasch, NP
• Peterson Pharmacy Inc (Peterson Pharmacy)
• Peterson Pharmacy Inc
• Andrew Nuzum Peterson, R.PH.
• Nicholas L Rabe, CRNA
• Thomas K Resan, MD
• Cassidy Anne Sanchez, PT
• School District of Hillsboro
• Danielle M Shapiro, MD

• Dermatology Physician in Hillsboro, WI
• Providers in Hillsboro, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.