Individual provider Active NPI

Clayton Ross Peterson, MD

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1750528477
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
232158 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 667-7000
NPI assigned
Jan 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 232158 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

62 Queensberry St Apt 404
Boston, MA 02215-5166
Phone (978) 505-5676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20151223001136 MA Practitioner - General Surgery 8820399454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Columbia University College of Physicians and Surgeons, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

777 N St
Berkshire Surgical Services of BMC
Pittsfield, MA 01201-4147
Phone (413) 445-6420

Hospital & facility affiliations

  • Berkshire Visiting Nurse Association Home health agency, Pittsfield, MA, CCN 227122
  • Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
  • North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304
  • Fairview Hospital Hospital, Great Barrington, MA, CCN 221302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)36
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232158MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Nov 5, 2015 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Nov 5, 2015 Accepting new patients
Hillcrest Family Health Center Surgery Past Accepting new patients
Berkshire Medical Center, Inc Past Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

71 Hospital Ave
Fl 3
North Adams, MA 01247
Phone (413) 664-4088

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: claytonpeterson@bfs.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1750528477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 QUEENSBERRY ST APT 404",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155166",
            "telephone_number": "978-505-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CLAYTON",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "232158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.