Jeffrey B Peterson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

016870 Issued in ME

Practice address

259 Main Street
Yarmouth, ME 04096

Phone

(207) 846-9602

Fax

(207) 846-6714

NPI assigned

Jul 12, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in ME

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: jeffrey.peterson.p1@direct.portlandchc.nextgenshare.com

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.

• Portland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1609120856
  NPD
• Portland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1982338240
  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1700811916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN ROAD WEST",
            "address_2": "SUITE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-828-0361",
            "fax_number": "207-874-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MAIN STREET",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "04096",
            "telephone_number": "207-846-9602",
            "fax_number": "207-846-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "016870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431962899",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Paulin
• Peaceful Me, PLLC
• Kaitlyn Pelletier, LMT
• Susan Michelle Penza-Clyve, PH.D.
• Cindy Mitchell Perkins, L.C.P.C.
• Patricia J Phillips, DO
• Barbara Piccirillo
• Marcelle Pick, RNC MSN NP
• Daniel C Pierce, MD
• Elizabeth B. Pierce, DO

• Pediatrics Physician in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.