NPIMap

Individual provider Active NPI

Daniel Joseph Peterson, MD

  • Internal Medicine Physician
  • Wyndmoor, PA
National Provider Identifier
1902883846
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD430498 Issued in PA
Practice address
8200 Flourtown Avenue
Suite 2
Wyndmoor, PA 19038-7969
Phone
(215) 836-5100
Fax
(215) 836-6011
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD430498 PA Primary

Addresses

Primary practice location

8200 Flourtown Avenue
Suite 2
Wyndmoor, PA 19038-7969

Mailing address

8200 Flourtown Avenue
Suite 2
Wyndmoor, PA 19038-7969
Phone (215) 836-5100

Other identifiers 1

IdentifierTypeStateIssuer
101958464MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070612000465 PA Practitioner - Internal MedicinePractitioner - Emergency Medicine 9638158249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8200 Flourtown Ave
Wyndmoor, PA 19038-7969
Phone (215) 836-5100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAMD430498PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Dec 26, 2022 Accepting new patients
Clinical Care Associates of the University of CurrentSince Dec 26, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Emergency Physician Associates of Pennsylvania, PC Past Accepting new patients
St Lukes Roosevelt Community Care Internal Medicine Past Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients

Locations

906 Bethlehem Pike
Fl 2
Glenside, PA 19038

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 6

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1902883846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 FLOURTOWN AVENUE",
            "address_2": "SUITE 2",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387969",
            "telephone_number": "215-836-5100",
            "fax_number": "215-836-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 FLOURTOWN AVENUE",
            "address_2": "SUITE 2",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387969",
            "telephone_number": "215-836-5100",
            "fax_number": "215-836-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD430498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101958464",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyndmoor, PA

Sources for this page

Verify at the official NPI Registry.