NPIMap

Individual provider Active NPI

Susan Petersen, MD

  • Family Medicine Physician
  • Billings, MT
National Provider Identifier
1861434037
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8399 Issued in MT
Practice address
2019 Broadwater Ave
Billings, MT 59102-4810
Phone
(406) 237-5200
Fax
(406) 237-5205
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8399 MT Primary

Addresses

Primary practice location

2019 Broadwater Ave
Billings, MT 59102-4810

Mailing address

2019 Broadwater Ave
Billings, MT 59102-4810
Phone (406) 237-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000833 MT Practitioner - Family Practice 8729114772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2900 12TH Ave N
Suite 400E
Billings, MT 59101-7514
Phone (406) 237-5770

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8399MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Montana CurrentSince Aug 3, 1998 Accepting new patients
SCL Health Medical Group - Billings, LLC CurrentSince Jan 24, 2015 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Jan 24, 2015 Accepting new patients
SCL Health Montana Current Accepting new patients

Locations

2019 Broadwater Ave
Billings, MT 59102
Phone (406) 237-5200

2750 Grand Ave
Billings, MT 59102
Phone (406) 237-4040

1041 N 29th St
Billings, MT 59101
Phone (303) 237-5577

2900 12th Ave N
Ste 400E
Billings, MT 59101
Phone (406) 238-6650

1027 N 27th St
Billings, MT 59101
Phone (406) 237-5110

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

Interoperability endpoints

  • Direct secure messaging: spetersen36782@direct.intermountainhealth.org

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1861434037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 BROADWATER AVE",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591024810",
            "telephone_number": "406-237-5200",
            "fax_number": "406-237-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 BROADWATER AVE",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591024810",
            "telephone_number": "406-237-5200",
            "fax_number": "406-237-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "8399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.