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DR. JEFFREY E PETERSEN MD NPI 1275551707


NPI Information

NPI: 1275551707
Provider Name: DR. JEFFREY E PETERSEN, MD
Classification: Dermatology - 207N00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1011 BOWLES AVE
SUITE 121
FENTON, MO
ZIP 63026
Phone: (314) 200-2713
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DR. Jeffrey E Petersen, MD is a dermatology in Fenton, MO with 29 years of experience. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. DR. Jeffrey E Petersen, MD NPI is 1275551707. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

1011 BOWLES AVE
SUITE 121
FENTON, MO
ZIP 63026-395
Phone: (314) 200-2713
Fax: (314) 200-2714

The NPI 1275551707 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.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks) (HCPCS:17311)
  • Tangential biopsy of single skin lesion (HCPCS:11102)
  • Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (HCPCS:17312)
  • Tangential biopsy of additional skin lesion (HCPCS:11103)
  • Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (HCPCS:13132)
  • Destruction of up to 14 skin growths (HCPCS:17110)
  • Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs (HCPCS:13121)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Removal and microscopic examination of growth of the trunk, arms, or legs (first stage, up to 5 tissue blocks) (HCPCS:17313)
  • Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips (HCPCS:14060)
  • Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)

The enumeration date for this NPI number is 7/17/2006 and was last updated on 7/25/2014.


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
1207ND0101XDermatologyMOHS-Micrographic Surgery2001020599MISSOURINo
2207N00000XDermatology2001020599MISSOURIYes

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
13177332OTHERMISSOURICIGNA
2205401409MEDICAIDMISSOURI
3853972OTHERMISSOURIANTHEM
4H28257MEDICARE UPIN
5146422OTHERMO-BLUE SHIELD
6703212OTHERMISSOURIAETNA

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

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