Adam Peters, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3754 Issued in MN

Practice address

1420 E College Dr
Marshall, MN 56258-2065

Phone

(320) 226-1237

NPI assigned

Sep 28, 2021

Sex

Male

Sole proprietor

Yes

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 MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carlson Tillisch Eye Clinic LTDGroup PAC ID 3072410521, 6 clinicians

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Carlson Tillisch Eye Clinic, LTD

  • Optometrist
  • Mankato, MN
  • NPI 1225116932
  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  dba Shopko Optical 4017

  • Eyewear Supplier
  • Saint Cloud, MN
  • NPI 1942866371
  Medicare reassignment Care Compare group
• Carlson Tillisch Eye Clinic, LTD

  • Optometrist
  • New Ulm, MN
  • NPI 1821159435
  NPD

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1851063952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 40TH AVE SW",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562654096",
            "telephone_number": "320-226-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E COLLEGE DR",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582065",
            "telephone_number": "320-226-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ADAM",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjali Rajesh Parmar
• Nishant Parmar, M.D.
• Terence James Parr, M.D.
• Chorus Paw
• Conner Lee Paxton
• Deric Wymer Peterson, AU.D.
• Jessica Ann Peterson, DC
• Kevin Warren Peterson, CRNA
• Kimberly Peterson, DNP, CPNP-PC
• Daisy Pierson

• Optometrist in Marshall, MN
• Providers in Marshall, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.