MICHAEL JAMES PETERSEN M.D. NPI 1902899057

NPI Information

  • NPI: 1902899057
  • Provider Name: MICHAEL JAMES PETERSEN, M.D.
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4 TECHNOLOGY DR
    SUITE 120
    EAST SETAUKET, NY
    ZIP 11733
  • Phone: (631) 246-8289

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NPI Details

Michael James Petersen, M.D. is a vascular surgery surgery in East Setauket, NY with 40 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Michael James Petersen, M.D. NPI is 1902899057. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BAYLOR COLLEGE OF MEDICINE
Graduation Year:1986

The provider's business location address is:

4 TECHNOLOGY DR
SUITE 120
EAST SETAUKET, NY
ZIP 11733-068
Phone: (631) 246-8289
Fax: (631) 246-8294

The NPI 1902899057 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, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Complete ultrasound study of arm and leg arteries (HCPCS:93923)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts (HCPCS:93978)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Complete ultrasound study of arm and leg arteries (HCPCS:93923)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Removal of muscle and/or tissue, 20.0 sq cm or less (HCPCS:11043)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ultrasonic guidance for blood vessel access (HCPCS:76937)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Varicose vein removal (HCPCS:NAN08)
  • Leg revascularization (restoring blood flow) (HCPCS:NAN01)

The enumeration date for this NPI number is 8/24/2005 and was last updated on 6/6/2016.

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
1174400000XSpecialist175936NEW YORKNo
22086S0129XSurgeryVascular Surgery175936NEW YORKYes

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
10714028004OTHERNEW YORKCIGNA HEALTHCARE
2990015026OTHERNEW YORKRR MEDICARE
3CS1072OTHERNEW YORKOXFORD HEALTH PLANS
42C4298OTHERNEW YORKHEALTHNET
52110430OTHERNEW MEXICOAETNA HEALTH PLANS
6S500051OTHERNEW YORKSUFFOLK HEALTH PLANS
711347567803OTHERNEW YORK1199 BENEFIT FUND
8GHI PPO CBPOTHERNEW MEXICO0103702
91261940OTHERNEW YORKUNITED HEALTHCARE
10F91904MEDICARE UPINNEW YORK
1168J011MEDICARE PINNEW YORK

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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