Dr Lauris J Petersen, MD is a medicare enrolled "Family Medicine" physician in Glenville, New York. 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 | |
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| Experience | 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. |
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Medical Education and Training:
- Dr Lauris J Petersen attended and graduated from in
NPI Data:
- NPI Number: 1629152301
- Provider Enumeration Date: 10/25/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
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 |
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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