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DR. RANDOLPH K. PETERSON M.D. NPI 1053380204


NPI Information

NPI: 1053380204
Provider Name: DR. RANDOLPH K. PETERSON, M.D.
Classification: Pathology - 207ZP0102X
Entity Type: Individual

Specialization: Anatomic Pathology & Clinical Pathology

PECOS Registration: Yes

Address:
6525 FRANCE AVE S
SUITE 200
EDINA, MN
ZIP 55435
Phone: (952) 927-6501
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DR. Randolph K. Peterson, M.D. is an anatomic pathology and clinical pathology pathology in Edina, MN with 31 years of experience. The provider is a pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. DR. Randolph K. Peterson, M.D. NPI is 1053380204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduation Year:1993

The provider's business location address is:

6525 FRANCE AVE S
SUITE 200
EDINA, MN
ZIP 55435-148
Phone: (952) 927-6501
Fax: (952) 653-1435

The NPI 1053380204 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 enumeration date for this NPI number is 3/17/2006 and was last updated on 11/10/2015.


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
1207ZP0102XPathologyAnatomic Pathology & Clinical Pathology40788MINNESOTAYes

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
111-00306OTHERMINNESOTAMEDICA
2984811017049OTHERMINNESOTAPREFERRED ONE
3G87779MEDICARE UPINMINNESOTA
4HP31830OTHERMINNESOTAHEALTHPARTNERS
5220033481OTHERMINNESOTARAILROAD MEDICARE
6220001635MEDICARE PINMINNESOTA
7525S5PEOTHERMINNESOTABLUE CROSS
8881029000MEDICAIDMINNESOTA

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: 4/28/2024

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.