Active NPI
Rosemary G Peterson, MD
- Pediatric Rheumatology Physician
- Austin, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rheumatology Physician
- License
- MT210365
- Practice address
- 1301 Barbara Jordan Blvd Ste 200E
Austin, TX 78723-3078 - Phone
- (512) 628-1880
- Fax
- (512) 628-1881
- NPI assigned
- Apr 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Rheumatology Physician | 2080P0216X | MT210365 | PA | Primary |
Addresses
Primary practice location
1301 Barbara Jordan Blvd Ste 200E
Austin, TX 78723-3078
Mailing address
924 E 50TH St
Austin, TX 78751-2704
Phone (610) 613-4480
Other practice location 1
725 Welch Rd
Palo Alto, CA 94304-1601
Phone (650) 497-8000
Other practice location 2
3401 Civic Center Blvd
Division of Pediatric Rheumatology
Philadelphia, PA 19104
Phone (215) 590-7180
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT210365 | PA | MD | Pediatric Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dell Children'S Medical Group | Current | Accepting new patients | |
| Dell Children'S Medical Group | Pediatric Rheumatology | Current | Accepting new patients |
| Dell Children'S Medical Group | Pediatric Rheumatology | Current | Accepting new patients |
Locations
1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800
1301 Barbara Jordan Blvd
Ste 200E
Austin, TX 78723
Phone (512) 628-1840
1301 Medical Pkwy
Ste 200
Cedar Park, TX 78613
Phone (512) 324-0975
1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800
Interoperability endpoints
- rosemary.peterson.1@8363.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Sleep Disorder Diagnostic Clinic/Center
- Austin, TX
- NPI 1124748249
-
- Pediatrics Physician
- Round Rock, TX
- NPI 1790103869
Pediatric Rheumatology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1992124481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 E 50TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787512704",
"telephone_number": "610-613-4480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 BARBARA JORDAN BLVD STE 200E",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787233078",
"telephone_number": "512-628-1880",
"fax_number": "512-628-1881"
}
],
"practiceLocations": [
{
"address_1": "725 Welch Rd",
"address_purpose": "LOCATION",
"city": "Palo Alto",
"state": "CA",
"postal_code": "943041601",
"country_code": "US",
"telephone_number": "650-497-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3401 Civic Center Blvd",
"address_2": "Division of Pediatric Rheumatology",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "19104",
"country_code": "US",
"telephone_number": "215-590-7180",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERSON",
"first_name": "ROSEMARY",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-10",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0216X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Rheumatology",
"state": "PA",
"license": "MT210365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.