Dr Jeffrey E Petersen, MD is a medicare enrolled "Dermatology" physician in Fenton, Missouri. He went to Indiana University School Of Medicine and graduated in 1995 and has 29 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice St Louis Dermatology Llc and his current practice location is
1011 Bowles Ave, Suite 121, Fenton, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 200-2713.
Dr Jeffrey E Petersen is licensed to practice in Missouri (license number 2001020599) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1275551707.
Physician's Profile
| Full Name | Dr Jeffrey E Petersen |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 29 Years |
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| Location | 1011 Bowles Ave, Fenton, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jeffrey E Petersen attended and graduated from Indiana University School Of Medicine in 1995
NPI Data:
- NPI Number: 1275551707
- Provider Enumeration Date: 07/17/2006
- Last Update Date: 07/25/2014
Medicare PECOS Information:
- PECOS PAC ID: 8527163286
- Enrollment ID: I20070425000332
Medical Identifiers
Medical identifiers for Dr Jeffrey E Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275551707 | NPI | - | NPPES |
| 703212 | Other | MO | AETNA |
| 146422 | Other | | MO-BLUE SHIELD |
| 205401409 | Medicaid | MO | |
| 853972 | Other | MO | ANTHEM |
| 3177332 | Other | MO | CIGNA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 2001020599 (Missouri) | Primary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 2001020599 (Missouri) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| St Louis Dermatology Llc | 7517197247 | 5 |
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. Dr Jeffrey E Petersen allows following entities to bill medicare on his behalf.
| Entity Name | St Louis Dermatology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760810543
PECOS PAC ID: 7517197247
Enrollment ID: O20140225002043 |
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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. Dr Jeffrey E Petersen 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 |
|---|
Dr Jeffrey E Petersen, MD
1011 Bowles Ave, Suite 121,
Fenton, MO 63026-2395
Ph: (314) 200-2713 | Dr Jeffrey E Petersen, MD
1011 Bowles Ave, Suite 121,
Fenton, MO 63026-2395
Ph: (314) 200-2713 |
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