Thomas L Peterson, MD is a medicare enrolled "Emergency Medicine" physician in Rice Lake, Wisconsin. His current practice location is
1700 W Stout St, Rice Lake, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 236-8100.
Thomas L Peterson is licensed to practice in Wisconsin (license number WI26696) 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 1609820620.
Physician's Profile
Full Name | Thomas L Peterson |
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Gender | Male |
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Speciality | Emergency Medicine |
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Location | 1700 W Stout St, Rice Lake, Wisconsin |
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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: 1609820620
- Provider Enumeration Date: 05/22/2006
- Last Update Date: 02/15/2010
Medicare PECOS Information:
- PECOS PAC ID: 9133193089
- Enrollment ID: I20050722000571
Medical Identifiers
Medical identifiers for Thomas L Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1609820620 | NPI | - | NPPES |
30653800 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | WI26696 (Wisconsin) | Primary |
207PE0004X | Emergency Medicine - Emergency Medical Services | WI26696 (Wisconsin) | Secondary |
207PP0204X | Emergency Medicine - Pediatric Emergency Medicine | WI26696 (Wisconsin) | Secondary |
207PT0002X | Emergency Medicine - Medical Toxicology | WI26696 (Wisconsin) | Secondary |
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. Thomas L Peterson allows following entities to bill medicare on his behalf.
Entity Name | Marshfield Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1952347981 PECOS PAC ID: 2264345206 Enrollment ID: O20031106000590 |
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Entity Name | Lakeview Medical Center Inc Of Rice Lake |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093201832 PECOS PAC ID: 6103737820 Enrollment ID: O20180817001484 |
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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. Thomas L 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 |
Thomas L Peterson, MD 1000 N Oak Ave, Marshfield, WI 54449-5703 Ph: (715) 387-5511 | Thomas L Peterson, MD 1700 W Stout St, Rice Lake, WI 54868-5000 Ph: (715) 236-8100 |
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