Charles Smith Peterson, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

28027 Issued in AZ

Practice address

3130 E Baseline Rd
Suite 101
Mesa, AZ 85204-7290

Phone

(480) 558-3744

Fax

(480) 558-3801

NPI assigned

Aug 10, 2005

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports MedicineAlso: Family Practice

Education

Northwestern University Feinberg Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Arizona Spine and Joint Hospital Hospital, Mesa, AZ, CCN 030107
• Honorhealth Scottsdale Thompson Peak Med Ctr Hospital, Scottsdale, AZ, CCN 030123

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.peterson.1@600.direct.athenahealth.com
• Direct secure messaging: charlespeterson@asjh.medalliesdirect.net

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.

• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832
  NPD
• VHS Outpatient Clinics, Inc.

  dba Arizona Sports Medicine Center (ASMC)

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1891302790
  NPD
• Orthopedic Specialists of North America, PLLC

  dba OrthoArizona

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1770812828
  NPD (past)

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

• Arizona Spine and Joint Hospital LLC

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1396745832
  Care Compare affiliation
• Honorhealth

  dba HonorHealth Scottsdale Thompson Peak Medical Center

  • General Acute Care Hospital
  • Scottsdale, AZ
  • NPI 1417152745
  Care Compare affiliation

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1952302143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 E VIA DE VENTURA STE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583358",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047290",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "CHARLES",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "28027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Petersen, DBH, LMFT, LISAC
• Amelia Peterson
• Beatrice J Peterson, DNP, PMHNP-BC
• Brian R. Peterson, D.D.S.
• Calli Tansa Peterson
• Denise Peterson, LIAC
• Eric Peterson
• Kelsey Peterson, LMSW
• Lana J. Peterson, PMHNP
• Laurie Lee Peterson, P.A.

• Sports Medicine (Family Medicine) Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Sports Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2019; 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.