Bruce P Peterson, MD is a medicare enrolled "Pediatrics" physician in Roscoe, Illinois. His current practice location is
5000 Prairie Rose Dr, Roscoe, Illinois. You can reach out to his office (for appointments etc.) via phone at
(815) 971-2000.
Bruce P Peterson is licensed to practice in Illinois (license number 036-053478) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1821108010.
Physician's Profile
Full Name | Bruce P Peterson |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 5000 Prairie Rose Dr, Roscoe, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1821108010
- Provider Enumeration Date: 08/30/2006
- Last Update Date: 01/29/2010
Medicare PECOS Information:
- PECOS PAC ID: 2668533233
- Enrollment ID: I20081202000372
Medical Identifiers
Medical identifiers for Bruce P Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1821108010 | NPI | - | NPPES |
036053478 | Medicaid | IL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 036-053478 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Bruce P Peterson allows following entities to bill medicare on his behalf.
Entity Name | Rockford Health Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bruce P Peterson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Bruce P Peterson, MD 5000 Prairie Rose Dr, Roscoe, IL 61073-7792 Ph: (815) 971-2000 | Bruce P Peterson, MD 5000 Prairie Rose Dr, Roscoe, IL 61073-7792 Ph: (815) 971-2000 |
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