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ALAN C PETERSON M.D. NPI 1477555225


NPI Information

NPI: 1477555225
Provider Name: ALAN C PETERSON, M.D.
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Individual
Organization: LUTHERAN MEDICAL GROUP LLC

PECOS Registration: Yes

Address:
7910 W JEFFERSON BLVD
SUITE 102
FORT WAYNE, IN
ZIP 46804
Phone: (260) 432-2297
Get Directions

Alan C Peterson, M.D. is a thoracic surgery cardiothoracic vascular surgery in Fort Wayne, IN with 44 years of experience. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. Alan C Peterson, M.D. NPI is 1477555225. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year:1980

The provider's business location address is:

7910 W JEFFERSON BLVD
SUITE 102
FORT WAYNE, IN
ZIP 46804-159
Phone: (260) 432-2297
Fax: (260) 434-6420

The NPI 1477555225 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • Ultrasound study of arteries and arterial grafts of one leg or limited (HCPCS:93926)
  • Heart artery bypass to repair one artery (HCPCS:33533)
  • Ultrasound study of arteries and arterial grafts of both legs (HCPCS:93925)

The enumeration date for this NPI number is 8/11/2005 and was last updated on 9/29/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)01031812AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1330005240OTHERINDIANARR MEDICARE
22907251MEDICAIDMICHIGAN
30518649MEDICAIDOHIO
4100096130MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.