Madeliene Alexandra Peterson, in American Fork, UT - Medicare Nurse Anesthetist, Certified Registered

Madeliene Alexandra Peterson, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in American Fork, Utah. Her current practice location is 170 N 1100 E, American Fork, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 855-3267.

Madeliene Alexandra Peterson is licensed to practice in Utah (license number 12058297-4406) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003698507.

Contact Information

	Madeliene Alexandra Peterson,
	170 N 1100 E, American Fork, UT 84003-2961
	(801) 855-3267
	(801) 855-3251

Map and Direction

Provider's Profile

Full Name	Madeliene Alexandra Peterson
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	170 N 1100 E, American Fork, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003698507
Provider Enumeration Date: 10/18/2023
Last Update Date: 12/26/2023

Medicare PECOS Information:

PECOS PAC ID: 6002250560
Enrollment ID: I20240223000397

Medical Identifiers

Medical identifiers for Madeliene Alexandra Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003698507	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	12058297-3102 (Utah)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	12058297-4406 (Utah)	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. Madeliene Alexandra Peterson allows following entities to bill medicare on her behalf.

Entity Name	Nph Anesthesia Of Utah Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366077273 PECOS PAC ID: 9537584313 Enrollment ID: O20200811001268

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. Madeliene Alexandra 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
Madeliene Alexandra Peterson, 2221 Lakeside Blvd Ste 600, Richardson, TX 75082-4416 Ph: (469) 505-1652	Madeliene Alexandra Peterson, 170 N 1100 E, American Fork, UT 84003-2961 Ph: (801) 855-3267

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in American Fork, UT

Kevin K Hair, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1014 E 220 N, American Fork, UT 84003 Phone: 801-763-5461
Preston Peterson Bird, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-492-1611
Mr. Michael Ryan Blaney, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-357-8818
Mrs. Vanessa Passanante, RN, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-855-3267 Fax: 801-855-3251
Graham Brent Prime, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-763-3300
Daniel William Bunker, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1159 E 200 N, #100, American Fork, UT 84003 Phone: 801-855-3372
Tisha C. Gordon, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-763-3300 Fax: 801-432-2668

Madeliene Alexandra Peterson, - Medicare Nurse Anesthetist, Certified Registered in American Fork, UT