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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NPI Details

DR. Jeffrey E Petersen, MD is a dermatology in Fenton, MO with 31 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.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks (HCPCS:17311)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks (HCPCS:17312)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Application of vein wound compression bandages on lower leg, ankle, and foot (HCPCS:29581)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks (HCPCS:17313)
  • Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) (HCPCS:J7308)
  • Application of light to destroy precancer skin growth (HCPCS:96567)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm (HCPCS:13152)
  • Repair of wound by transferring skin, each additional 30.0 sq cm (HCPCS:14302)
  • Repair of wound by transferring skin, 30.1-60.0 sq cm (HCPCS:14301)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less (HCPCS:14060)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm (HCPCS:14061)
  • Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm (HCPCS:17263)
  • New patient office or other outpatient visit, 15-29 minutes (HCPCS:99202)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm (HCPCS:13151)
  • Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
  • Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm (HCPCS:17262)
  • Biopsy of ear (HCPCS:69100)
  • Complicated repair of wound of trunk, 2.6-7.5 cm (HCPCS:13101)
  • Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm (HCPCS:14041)
  • Removal of varicose veins of arm or leg, 10-20 incisions (HCPCS:37765)
  • Injection into skin growth, 1-7 growths (HCPCS:11900)
  • Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm (HCPCS:17273)
  • Creation of flap graft to eyelids, nose, ears, lips, or mouth (HCPCS:15576)
  • Transfer of skin flap to eyelids, nose, ears, or lips (HCPCS:15630)
  • Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm (HCPCS:12042)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Varicose vein removal (HCPCS:NAN08)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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