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DR. GEORGE DWIGHT PETERSON M.D. NPI 1942397799


NPI Information

NPI: 1942397799
Provider Name: DR. GEORGE DWIGHT PETERSON, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 10D0980633

Address:
5450 MACDONALD AVENUE
SUITE 12
KEY WEST, FL
ZIP 33040
Phone: (305) 293-9555
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DR. George Dwight Peterson, M.D. is a specialist in Key West, FL with 39 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. George Dwight Peterson, M.D. NPI is 1942397799. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: PONCE SCHOOL OF MEDICINE
Graduation Year:1985

The provider's business location address is:

5450 MACDONALD AVENUE
SUITE 12
KEY WEST, FL
ZIP 33040
Phone: (305) 293-9555
Fax: (305) 293-9415

The NPI 1942397799 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 CLIA number assigned to this NPI record is 10D0980633 - physician office with a certificate type of Certificate of Waiver.

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.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 10/5/2006 and was last updated on 11/11/2008.


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
1174400000XSpecialistME0065007FLORIDAYes

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
1373887600MEDICAIDFLORIDA
2F70026MEDICARE UPINFLORIDA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.