MARY KAY PETERSON MD NPI 1508805656

NPI Information

  • NPI: 1508805656
  • Provider Name: MARY KAY PETERSON, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3680 BROADWAY
    FORT MYERS, FL
    ZIP 33901
  • Phone: (239) 936-2316

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NPI Details

Mary Kay Peterson, MD is a diagnostic radiology radiology in Fort Myers, FL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Mary Kay Peterson, MD NPI is 1508805656. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3680 BROADWAY
FORT MYERS, FL
ZIP 33901-005
Phone: (239) 936-2316

The NPI 1508805656 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer 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.

  • Injection, gadoterate meglumine, 0.1 ml (HCPCS:A9575)
  • Screening 3d breast mammography (HCPCS:77063)
  • Screening mammography (HCPCS:77067)
  • Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) (HCPCS:G0279)
  • Diagnostic mammography of both breasts (HCPCS:77066)
  • Diagnostic mammography of 1 breast (HCPCS:77065)
  • Limited ultrasound scan of 1 breast (HCPCS:76642)
  • Biopsy of breast and placement of locating device using x-ray with needle, first growth (HCPCS:19081)
  • Biopsy of breast and placement of locating device using ultrasound, first growth (HCPCS:19083)
  • Mri scan of both breasts (HCPCS:77049)

The enumeration date for this NPI number is 6/5/2006 and was last updated on 5/29/2008.

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
12085R0202XRadiologyDiagnostic RadiologyME77132FLORIDAYes

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
17405122OTHERAETNA PPO
2257739900MEDICAIDFLORIDA
346568OTHERBCBS
4300112784MEDICARE PIN
5G96077MEDICARE UPIN
646568AMEDICARE PINFLORIDA
72439859OTHERAETNA HMO
8ME77132OTHERFLORIDAFLORIDA LICENSE

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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