FREDERICK PETERSON MD NPI 1215913165

NPI Information

NPI: 1215913165
Provider Name: FREDERICK PETERSON, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 6100 MINTON RD NW
STE104
PALM BAY, FL
ZIP 32907
Phone: (321) 724-1172

Map and Directions

Get Directions

NPI Details

Frederick Peterson, MD is a family medicine in Palm Bay, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Frederick Peterson, MD NPI is 1215913165. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6100 MINTON RD NW
STE104
PALM BAY, FL
ZIP 32907-975
Phone: (321) 724-1172
Fax: (321) 724-9024

The NPI 1215913165 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.

Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)

The enumeration date for this NPI number is 12/21/2005 and was last updated on 3/30/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		ME32196	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080185086	OTHER	FLORIDA	RAILROAD MEDICARE
2	2049145010	OTHER	FLORIDA	CIGNA
3	62193	OTHER	FLORIDA	BLUE CROSS BLUE SHIELD
4	2830929	OTHER	FLORIDA	AETNA
5	200859	OTHER	FLORIDA	WELLCARE
6	038494100	MEDICAID	FLORIDA
7	5840654	OTHER	FLORIDA	AETNA

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: 11/21/2025

NPI Synchronization or Removal

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.

Previous NPI

Next NPI