Dr Lauris J Petersen, MD is a medicare enrolled "Family Medicine" physician in Glenville, New York. He went to Georgetown University School Of Medicine and graduated in 1995 and has 29 years of diverse experience with area of expertise as Family Practice. His current practice location is
15 Glenridge Rd, Glenville, New York. You can reach out to his office (for appointments etc.) via phone at
(518) 399-0909.
Dr Lauris J Petersen is licensed to practice in New York (license number 213320) 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 1629152301.
Physician's Profile
Full Name | Dr Lauris J Petersen |
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Gender | Male |
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Speciality | Family Practice |
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Experience | 29 Years |
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Location | 15 Glenridge Rd, Glenville, New York |
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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. |
Medical Education and Training:
- Dr Lauris J Petersen attended and graduated from Georgetown University School Of Medicine in 1995
NPI Data:
- NPI Number: 1629152301
- Provider Enumeration Date: 10/25/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0648254995
- Enrollment ID: I20040617000227
Medical Identifiers
Medical identifiers for Dr Lauris J Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629152301 | NPI | - | NPPES |
000491234003 | Other | NY | BLUE SHIELD OF NENY |
76V271 | Other | NY | EMPIRE BLUE |
10031080 | Other | NY | CDPHP |
714547 | Other | NY | MVP |
P00315575 | Other | NY | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 213320 (New York) | Primary |
Medical Facilities Affiliation
Facility Name | Location | Facility Type |
Ellis Hospital | Schenectady, NY | Hospital |
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 Lauris J Petersen allows following entities to bill medicare on his behalf.
Entity Name | Saratoga Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033371166 PECOS PAC ID: 6406740273 Enrollment ID: O20040402000837 |
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Entity Name | Lauris J. Petersen Md Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1659563989 PECOS PAC ID: 9638153976 Enrollment ID: O20040615001124 |
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Entity Name | Saratoga Regional Medical , P.c |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1982094827 PECOS PAC ID: 9032438544 Enrollment ID: O20150505002182 |
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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 Lauris J 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 Lauris J Petersen, MD 5 Monarda Dr, Scotia, NY 12302-4202 Ph: () - | Dr Lauris J Petersen, MD 15 Glenridge Rd, Glenville, NY 12302-4520 Ph: (518) 399-0909 |
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