ERIK JON PETERSON MD NPI 1619051869

NPI Information

NPI: 1619051869
Provider Name: ERIK JON PETERSON, MD
Classification: Internal Medicine - 207RR0500X
Entity Type: Individual

Specialization: Rheumatology

PECOS Registration: Yes

Address:
516 DELAWARE ST SE
PWB SIXTH FLOOR, CLINIC 6A
MINNEAPOLIS, MN
ZIP 55455
Phone: (612) 625-8690
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Erik Jon Peterson, MD is a rheumatology internal medicine in Minneapolis, MN with 34 years of experience. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. Erik Jon Peterson, MD NPI is 1619051869. 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:1990

The provider's business location address is:

516 DELAWARE ST SE
PWB SIXTH FLOOR, CLINIC 6A
MINNEAPOLIS, MN
ZIP 55455-356
Phone: (612) 625-8690

The NPI 1619051869 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 10/24/2006 and was last updated on 10/26/2012.

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	207R00000X	Internal Medicine		45093	MINNESOTA	No
2	207RR0500X	Internal Medicine	Rheumatology	45093	MINNESOTA	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	32-00093	OTHER	MINNESOTA	MEDICA CHOICE
2	244A6PE	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
3	090883500	MEDICAID	MINNESOTA
4	1031720	OTHER	MINNESOTA	PREFERRED ONE
5	142412	OTHER	MINNESOTA	UCARE
6	34260300	MEDICAID	WISCONSIN
7	1686374	OTHER	MINNESOTA	ARAZ
8	HP39455	OTHER	MINNESOTA	HEALTH PARTNERS
9	F57184	MEDICARE UPIN
10	32-00003	OTHER	MINNESOTA	MEDICA PRIMARY

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

NPI Synchronization or Removal

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