Michael Warren Peterson, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

7247463-1204 Issued in UT

Practice address

114 East 800 North
Spanish Fork, UT 84660

Phone

(801) 794-1490

Fax

(801) 794-1495

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, AZ2 enrollments

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 2

Specialty

Dermatology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Desert Dermatology and Surgery PC 11 clinicians

Springville Dermatology and Diagnostics PC 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Springville Dermatology & Diagnostics PC

  • Dermatopathology Physician
  • Springville, UT
  • NPI 1992144364

  UT

  Medicare reassignment Care Compare group NPD Authorized official
• Arizona Desert Dermatology and Surgery PC

  • Dermatology Physician
  • Kingman, AZ
  • NPI 1386702546

  AZ, Dermatology

  Medicare reassignment Care Compare group NPD
• Advanced Wound Care of Utah PLLC

  • Foot & Ankle Surgery Podiatrist
  • Cedar City, UT
  • NPI 1568233898

  UT

  Medicare reassignment NPD
• Aspen Dermatopathology

  • Clinical Medical Laboratory
  • Springville, UT
  • NPI 1689943300
  NPD (past)
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1770634909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 N MAIN ST",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846631034",
            "telephone_number": "801-704-7001",
            "fax_number": "801-210-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 EAST 800 NORTH",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "84660",
            "telephone_number": "801-794-1490",
            "fax_number": "801-794-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MICHAEL",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "7247463-1204",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "47784-021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Peters
• Cammy Peterson
• Carly Lynne Peterson, NP
• Chad Peterson, D.O.
• Courtney Peterson, FNP-C
• Warren Albert Peterson, D.O.
• Steel Grant Pia, LMT
• Xavier A Pierce Rocha, PA
• Emily Pittam
• Haley Jorgensen Pledger, PA-C

• All providers in Spanish Fork, UT
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.