Travis Dale Peterson, RN in Provo, UT - Medicare Nurse Practitioner

Travis Dale Peterson, RN is a medicare enrolled "Nurse Practitioner - Neonatal" in Provo, Utah. His current practice location is 1034 N 500 W, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 357-7414.

Travis Dale Peterson is licensed to practice in Utah (license number 8058003-4405) 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 1467195552.

Contact Information

	Travis Dale Peterson, RN
	1034 N 500 W, Provo, UT 84604-3380
	(801) 357-7414
	Not Available

Map and Direction

Provider's Profile

Full Name	Travis Dale Peterson
Gender	Male
Speciality	Nurse Practitioner - Neonatal
Location	1034 N 500 W, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467195552
Provider Enumeration Date: 04/15/2022
Last Update Date: 01/09/2023

Medicare PECOS Information:

PECOS PAC ID: 6002285178
Enrollment ID: I20221212002174

Medical Identifiers

Medical identifiers for Travis Dale Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467195552	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LN0000X	Nurse Practitioner - Neonatal	8058003-4405 (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. Travis Dale Peterson allows following entities to bill medicare on his behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303

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. Travis Dale 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
Travis Dale Peterson, RN Po Box 27128, Salt Lake City, UT 84127-0128 Ph: () -	Travis Dale Peterson, RN 1034 N 500 W, Provo, UT 84604-3380 Ph: (801) 357-7414

Reviews and Comments

Nurse Practitioner Nurses in Provo, UT

Sharla Morgan, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 303, Provo, UT 84604 Phone: 801-356-1300 Fax: 801-356-1304
Ashley Saunders, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1055 N 500 W Bldg A, Provo, UT 84604 Phone: 801-812-5033 Fax: 801-812-5034
Mr. Michael Frank Gibson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1355 North University Ave, Suite 210, Provo, UT 84604 Phone: 801-373-8930 Fax: 801-377-6811
Connie Denise Taylor, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 75 S 200 E, Ste 100, Provo, UT 84606 Phone: 801-877-5801 Fax: 801-877-5802
Jennifer Lynn Osborne, APRN, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 101, Provo, UT 84604 Phone: 801-373-4366 Fax: 801-429-8191
Amber Elexis Marsh, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 395 W Cougar Blvd, Provo, UT 84604 Phone: 801-357-7850
Melissa Sue Guest, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 750 N Freedom Blvd, Provo, UT 84601 Phone: 801-373-4760

Travis Dale Peterson, RN - Medicare Nurse Practitioner in Provo, UT