Individual provider Active NPI

Ryan S Peterson, MD

  • Anesthesiology Physician
  • Round Rock, TX
National Provider Identifier
1942610241
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
R5451 Issued in TX
Practice address
302 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0200
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 19256 NH
Anesthesiology Physician 207L00000X R5451 TX Primary

Addresses

Primary practice location

302 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 2

IdentifierTypeStateIssuer
1033956MedicaidVT
3115445MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpeterson61484@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210526002932 TX Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 2961784293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical School at San Antonio, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians
Cogent Healthcare of Texas PAGroup PAC ID 8628076924, 113 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

2400 Round Rock Ave
Round Rock, TX 78681-4004
Phone (512) 341-1000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

2600 E Pflugerville Pkwy
Pflugerville, TX 78660-5999

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
  • Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
  • St David'S Medical Center Hospital, Austin, TX, CCN 450431

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19256NHMDAnesthesiology Physician
R5451TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Anesthesiology CurrentSince Aug 10, 2021 Accepting new patients
Cogent Healthcare of Texas, PA CurrentSince Apr 1, 2021 Accepting new patients
Scott & White Clinic Anesthesiology Current Accepting new patients
Scott & White Clinic CurrentSince Aug 10, 2021 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

3801 N Lamar Blvd
Austin, TX 78756
Phone (512) 407-7000

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2600 E Pflugerville Pkwy
Ste 100
Pflugerville, TX 78660
Phone (512) 654-6100

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

302 University Blvd
Round Rock, TX 78665
Phone (512) 218-6330

300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: rpeterson61484@direct.sw.org
  • Direct secure messaging: rpeterson315536@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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 3

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1942610241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RYAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "19256",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "R5451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033956",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3115445",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpeterson61484@direct.sw.org",
            "affiliation": "N",
            "address_1": "302 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.