Dr Robert Todd Petersen, DC, OPAC, ATC, LAT is a medicare enrolled "Chiropractor - Sports Physician" in Dallas, Texas. He graduated from nursing school in 2002 and has 22 years of diverse experience with area of expertise as Chiropractic. His current practice location is
3408 Milton Ave, Dallas, Texas. You can reach out to his office (for appointments etc.) via phone at
(214) 739-2225.
Dr Robert Todd Petersen is licensed to practice in Texas (license number 9289) 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 1811917172.
Provider's Profile
| Full Name | Dr Robert Todd Petersen |
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| Gender | Male |
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| Speciality | Chiropractic |
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| Experience | 22 Years |
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| Location | 3408 Milton Ave, Dallas, Texas |
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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 Robert Todd Petersen graduated from nursing school in 2002
NPI Data:
- NPI Number: 1811917172
- Provider Enumeration Date: 07/20/2006
- Last Update Date: 10/30/2014
Medicare PECOS Information:
- PECOS PAC ID: 6406930759
- Enrollment ID: I20080225000633
Medical Identifiers
Medical identifiers for Dr Robert Todd Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811917172 | NPI | - | NPPES |
| 607194 | Other | TX | BCBS ID NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (Texas) | Secondary |
| 111NS0005X | Chiropractor - Sports Physician | 9289 (Texas) | Primary |
| 111NS0005X | Chiropractor - Sports Physician | 5118449-1202 (Utah) | 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. Dr Robert Todd Petersen allows following entities to bill medicare on his behalf.
| Entity Name | Park Cities Chirosport Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114160827
PECOS PAC ID: 4082765375
Enrollment ID: O20090626000163 |
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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 Robert Todd 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 Robert Todd Petersen, DC, OPAC, ATC, LAT
3408 Milton Ave,
Dallas, TX 75205-1338
Ph: (214) 739-2225 | Dr Robert Todd Petersen, DC, OPAC, ATC, LAT
3408 Milton Ave,
Dallas, TX 75205-1338
Ph: (214) 739-2225 |
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