Briana Marie Peterson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001595 Issued in CT

Practice address

574 E Middle Tpke
Manchester, CT 06040-3730

Phone

(860) 646-4334

Fax

(860) 646-7020

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Select Physical Therapy of Connecticut Limited PartnershipGroup PAC ID 9638080625, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: briana.peterson.npi1770694945.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment Care Compare group
• Select Physical Therapy of Connecticut Limited Partnership

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Storrs, CT
  • NPI 1639148125
  Care Compare group
• Family Medicine Center,LLC

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1427240910
  NPD (past)
• Prohealth Physicians, Inc.

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1003996463
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1770694945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 E MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403730",
            "telephone_number": "860-646-4334",
            "fax_number": "860-646-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 E MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403730",
            "telephone_number": "860-646-4334",
            "fax_number": "860-646-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRIANA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toscha M. Pertillar, MSW
• Trisha Lyn Pesce, M.D.
• Kelly Ellen Pestey, COTA
• Stephen M. Peszynski, DPT
• Daniel E. Petashnick, M.D.
• Trey M Peterson
• Samantha Petillo, PHARMD
• Vladrose Petit-Frere, B.A.
• Pamela J Petoskey
• Jeannette E Petrie-Smith

• Medical Physician Assistant in Manchester, CT
• Providers in Manchester, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.