Craig Jon Peterson, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

K0993 Issued in TX

Practice address

3445 Executive Center Dr
Suite 250
Austin, TX 78731-1678

Phone

(512) 579-4000

Fax

(512) 439-2814

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, DE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pathology

Education

University of Minnesota Medical School, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom and HuangGroup PAC ID 7113942798, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
• St David'S Medical Center Hospital, Austin, TX, CCN 450431

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom & Huang

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1255395810
  Medicare reassignment Care Compare group NPD

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

• St Davids Healthcare Partnership LP LLP

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1912963307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CRAIG",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "K0993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P080P9346",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Paige Jordan Peterson Sconzo, AU.D.
• Arthur Darwin Peterson, D.C.
• Betty Peterson, PHD
• Camila Rose Peterson
• Cory Peterson, P.T., D.P.T.
• Daniel Peterson
• Daniel L Peterson, M.D.
• David Matthew Peterson, PT
• Ellen Davis Peterson, CNS
• Genevieve Peterson

• Anatomic Pathology & Clinical Pathology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Anatomic Pathology & Clinical Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; 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.