Randolph E Peterson, MD is a medicare enrolled "Orthopaedic Surgery" physician in Ontario, Oregon. His current practice location is
840 Sw 4th Ave, Ontario, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 889-2899.
Randolph E Peterson is licensed to practice in Oregon (license number 19969) 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 1669461364.
Physician's Profile
Full Name | Randolph E Peterson |
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Gender | Male |
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Speciality | Orthopaedic Surgery |
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Location | 840 Sw 4th Ave, Ontario, Oregon |
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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: 1669461364
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 6305826421
- Enrollment ID: I20120124000946
Medical Identifiers
Medical identifiers for Randolph E Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669461364 | NPI | - | NPPES |
135827 | Medicaid | OR | |
838281001 | Other | OR | BCBS OF OR |
003426400 | Other | ID | IDAHO MEDICAID EDS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207X00000X | Orthopaedic Surgery | 19969 (Oregon) | 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. Randolph E Peterson allows following entities to bill medicare on his behalf.
Entity Name | Weiser Valley Hospital District |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1255364030 PECOS PAC ID: 5294704276 Enrollment ID: O20050124000126 |
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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. Randolph E 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 |
Randolph E Peterson, MD Po Box 1460, Ontario, OR 97914-1066 Ph: (541) 889-2899 | Randolph E Peterson, MD 840 Sw 4th Ave, Ontario, OR 97914-2627 Ph: (541) 889-2899 |
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