Alice Ruth Peterson, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2837 Issued in AZ

Practice address

4545 E Chandler Blvd Ste 104
Phoenix, AZ 85048-7647

Phone

(480) 728-4400

Fax

(480) 728-4411

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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 AZ

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

Arizona College of Osteopathic Medicine Mid Western University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sjhmc Physician Services 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dignity Health at Home Home health agency, Chandler, AZ, CCN 037281
• Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Sjhmc Physician Services

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005

  AZ

  Medicare reassignment Care Compare group
• St. Joseph'S Hospital and Medical Center

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD
• University Sports Medicine PC

  • Sports Medicine (Family Medicine) Physician
  • Phoenix, AZ
  • NPI 1477587335
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088

  Hospital

  Care Compare affiliation
• Dignity Health at Home, LLC

  • Home Health Agency
  • Chandler, AZ
  • NPI 1831678218
  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1871654418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487647",
            "telephone_number": "480-728-4400",
            "fax_number": "480-728-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 S Dobson Rd Ste B113",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245667",
            "country_code": "US",
            "telephone_number": "480-728-5020",
            "fax_number": "480-899-5023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ALICE",
        "middle_name": "RUTH",
        "name_prefix": "Miss",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2837",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Diane Petersen
• Ryan Petersen, RBT
• Scott Richard Petersen, M.D.
• Tayler Sierra Petersen, SLPA
• Patti Jo Peterson-Balliet, RN CPNP
• Alison M Peterson, PA-C
• Beverly A Peterson, LNA
• Caleb Eldon Peterson, M.S., CCC-SLP
• Carolyn G Peterson, P.A. - C
• Carrie Jean Peterson, DNP

• All providers in Phoenix, AZ
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.