Dr Roger Leslie Petersen, OD is a medicare enrolled "Optometrist" provider in Higginsville, Missouri. His current practice location is
1817 Main St, Higginsville, Missouri. You can reach out to his office (for appointments etc.) via phone at
(660) 584-2956.
Dr Roger Leslie Petersen is licensed to practice in Missouri (license number TO2272) 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 1679515787.
Healthcare Provider's Profile
Full Name | Dr Roger Leslie Petersen |
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Gender | Male |
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Speciality | Optometrist |
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Location | 1817 Main St, Higginsville, Missouri |
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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: 1679515787
- Provider Enumeration Date: 06/12/2006
- Last Update Date: 10/29/2016
Medicare PECOS Information:
- PECOS PAC ID: 5294843181
- Enrollment ID: I20120209000418
Medical Identifiers
Medical identifiers for Dr Roger Leslie Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679515787 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | TO2272 (Missouri) | Primary |
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 Roger Leslie 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 Roger Leslie Petersen, OD 1817 Main St, Higginsville, MO 64037-1524 Ph: (660) 584-2956 | Dr Roger Leslie Petersen, OD 1817 Main St, Higginsville, MO 64037-1524 Ph: (660) 584-2956 |
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