David Ian Peterson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0007841 Issued in CO

Practice address

9101 Kimmer Dr
Lone Tree, CO 80124-8454

Phone

(303) 424-2535

Fax

(303) 835-4623

NPI assigned

Apr 24, 2023

Last updated

Jul 28, 2025By the provider in NPPES

Sex

Male

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 CO

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portercare Adventist Health SystemGroup PAC ID 0941110886, 770 clinicians

Peak Gastroenterology AssociatesGroup PAC ID 2961484365, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Castle Rock Hospital, Castle Rock, CO, CCN 060125

Merit-based Incentive Payment System (MIPS)

Final score

85.96 of 100Reported as group

Quality

78.58

Promoting interoperability

100

Improvement activities

40

Cost

74.61

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peak Gastroenterology Associates

  • Gastroenterology Physician
  • Colorado Springs, CO
  • NPI 1023112117
  Medicare reassignment Care Compare group
• Portercare Adventist Health System

  dba Affiliated Ear, Nose & Throat Physicians

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1760761928
  Medicare reassignment Care Compare group
• Portercare Adventist Health System

  dba AdventHealth Medical Group Gynecologic Oncology at Castle Rock

  • Gynecologic Oncology Physician
  • Castle Rock, CO
  • NPI 1871307314
  NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group Urology at Lakewood

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD
• Optum Peak Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Colorado Springs, CO
  • NPI 1316678311
  NPD (past)
• Peak Gastroenterology ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Lone Tree, CO
  • NPI 1679231211
  NPD (past)
• Peak Gastroenterology Associates PC

  • Gastroenterology Physician
  • Colorado Springs, CO
  • NPI 1184339624
  NPD (past)
• Portercare Adventist Health System

  dba AdventHealth Medical Group OB/GYN at Cornerstar

  • Obstetrics & Gynecology Physician
  • Aurora, CO
  • NPI 1811289366
  NPD (past)
• Surgical Center of Peak Endoscopy, LLC

  • Ambulatory Surgical Clinic/Center
  • Colorado Springs, CO
  • NPI 1912388026
  NPD (past)

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

• Portercare Adventist Health System

  dba Adventhealth Castle Rock

  • General Acute Care Hospital
  • Castle Rock, CO
  • NPI 1912249590
  Care Compare affiliation

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1891482360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 MEADOWS BLVD STE 300",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 KIMMER DR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248454",
            "telephone_number": "303-424-2535",
            "fax_number": "303-835-4623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2352 Meadows Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Castle Rock",
            "state": "CO",
            "postal_code": "801098419",
            "country_code": "US",
            "telephone_number": "303-842-2362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DAVID",
        "middle_name": "IAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007841",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0007841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.