Wallace Cary Peterson Jr., MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

16442 Issued in NE

Practice address

4101 Tiger Lily Rd Ste 100
Lincoln, NE 68516-5587

Phone

(402) 420-7000

Fax

(402) 420-6969

NPI assigned

Oct 26, 2005

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 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Hematology/Oncology

Education

University of Nebraska College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer Partners of Nebraska PCGroup PAC ID 9436148426, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center, Inc Hospital, Falls City, NE, CCN 281352
• Pawnee County Memorial Hospital Hospital, Pawnee City, NE, CCN 281302
• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• Crete Area Medical Center Hospital, Crete, NE, CCN 281354
• Johnson County Hospital Hospital, Tecumseh, NE, CCN 281350

Merit-based Incentive Payment System (MIPS)

Final score

86.58 of 100Reported as group

Quality

99.74

Promoting interoperability

83

Improvement activities

40

Cost

64.7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: admin@sncc.oncoemrdirect.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.

• Cancer Partners of Nebraska PC

  • Hematology & Oncology Physician
  • Lincoln, NE
  • NPI 1437111408
  Medicare reassignment Care Compare group NPD
• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065

  Hematology & Oncology

  Medicare reassignment NPD
• Cancer Partners of Nebraska PC

  dba Cancer Partners of Nebraska at KCC

  • Hematology & Oncology Physician
  • Kearney, NE
  • NPI 1649151531
  NPD
• The Physician Network

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1437184652
  NPD (past)

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  dba Bryan Medical Center Laboratory

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Community Medical Center, Inc.

  • Critical Access Hospital
  • Falls City, NE
  • NPI 1881643484
  Care Compare affiliation
• Crete Area Medical Center

  • Critical Access Hospital
  • Crete, NE
  • NPI 1063463958
  Care Compare affiliation
• Johnson County Hospital

  • Critical Access Hospital
  • Tecumseh, NE
  • NPI 1285624825
  Care Compare affiliation
• Pawnee County Memorial Hospital

  • Critical Access Hospital
  • Pawnee City, NE
  • NPI 1992759781
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1760472039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "WALLACE",
        "middle_name": "CARY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NE",
            "license": "16442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000870A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32276",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3600017",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "1242",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@sncc.oncoemrdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4101 Tiger Lily Rd Ste 100",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685165587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nolan R Peterson, CRNA
• Sandra Sue Peterson
• Stephanie M Peterson, MD
• Sydney Gail Peterson, OTD, OTR/L
• Tiana Brooke Peterson, DO
• Taylor A Petitt, OT
• Breanna Petracek
• Aimee N Petray
• Meredith Petrick
• Gina Michelle Petrie

• Hematology & Oncology Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Hematology & Oncology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.