NPIMap

Individual provider Active NPI

Eric M Peterson, MD

  • Family Medicine Physician
  • Boone, IA
National Provider Identifier
1710955877
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33111 Issued in IA
Practice address
1115 S Marshall St
Boone, IA 50036-5304
Phone
(515) 432-2335
Fax
(515) 432-2357
NPI assigned
Mar 14, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33111 IA Primary

Addresses

Primary practice location

1115 S Marshall St
Boone, IA 50036-5304

Mailing address

1115 S Marshall St
Boone, IA 50036-5304
Phone (515) 432-2335

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcfmboones@cynchealthdsm.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051229000479 IA Practitioner - Family Practice 9133141468 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone County Family Medicine TRGroup PAC ID 0941192751, 8 clinicians

Practice addresses (Care Compare)

1115 S Marshall St
Boone, IA 50036-5304
Phone (515) 432-2335

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.13 of 100Reported as individual
Quality
74.78
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33111IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Family Medicine TR Family Medicine CurrentSince Aug 1, 2002 Accepting new patients
Boone County Hospital Current Accepting new patients
Madrid Family Practice Clinic CurrentSince Aug 22, 2011 Accepting new patients
Boone County Hospital Current Accepting new patients
Boone County Hospital CurrentSince Jul 1, 2016 Accepting new patients
Madison County Memorial Hospital Past Accepting new patients
Mercy Clinics, Inc. PastSince Aug 22, 2011 Accepting new patients

Locations

1215 Duff Ave
Ames, IA 50010
Phone (515) 239-4400

1015 Union St
Boone, IA 50036
Phone (515) 432-3140

1115 S Marshall St
Boone, IA 50036
Phone (515) 432-2335

120 S Story St
Boone, IA 50036
Phone (515) 432-3460

623 W North St
Madrid, IA 50156
Phone (515) 433-8461

Interoperability endpoints

  • Direct secure messaging: bcfmboones@cynchealthdsm.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Westhaven CommunityBoone, IA, CCN 165498 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control
Adp of the SNF		 Apr 1, 2011
Jan 20, 2025
Jan 22, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1710955877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S MARSHALL ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365304",
            "telephone_number": "515-432-2335",
            "fax_number": "515-432-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S MARSHALL ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365304",
            "telephone_number": "515-432-2335",
            "fax_number": "515-432-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ERIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcfmboones@cynchealthdsm.org",
            "affiliation": "N",
            "address_1": "1115 S Marshall St",
            "city": "Boone",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500365304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boone, IA

Sources for this page

Verify at the official NPI Registry.