MADELIENE ALEXANDRA PETERSON
NPI 1003698507
Nurse Anesthetist, Certified Registered in American Fork, UT
About Madeliene Alexandra Peterson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MADELIENE ALEXANDRA PETERSON (NPI 1003698507) is an individual nurse anesthetist, certified registered in American Fork, Utah, licensed in Utah (12058297-4406) and active in the NPI registry since October 2023. She is affiliated with American Fork Hospital and is a graduate of Other.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Madeliene Alexandra Peterson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
American Fork Hospital
Acute Care Hospitals · American Fork, UTOrem Community Hospital
Acute Care Hospitals · Orem, UTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
AMERICAN FORK, UT 84003
AMERICAN FORK, UT 84003
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Madeliene Peterson's NPI number?
The NPI number for Madeliene Peterson is 1003698507. It was assigned to this individual provider in the NPPES registry on October 18, 2023. The provider is also known as Madeliene Alexandra Jacob.
Where is Madeliene Peterson located?
Madeliene Peterson practices at 170 N 1100 E, American Fork, UT 84003. The listed phone number is (801) 855-3300.
What is Madeliene Peterson's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Madeliene Peterson enrolled in Medicare?
Yes. Madeliene Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Madeliene Peterson affiliated with any hospitals?
According to CMS data, Madeliene Peterson is affiliated with American Fork Hospital and Orem Community Hospital.
When was this NPI record last updated?
The NPPES record for Madeliene Peterson was last updated on April 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Madeliene Alexandra Peterson · NPI 1003698507
Nurse Anesthetist, Certified Registered physician in American Fork, Utah. Individual provider, active in the CMS NPPES registry since October 18, 2023.
## Identity
- **NPI:** 1003698507 (Entity type: Individual)
- **Enumerated:** October 18, 2023
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 12058297-4406 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 170 N 1100 E, American Fork, UT 84003-2961
- **Phone:** (801) 855-3300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Medical school:** Other
## Record status
- **NPPES last updated:** April 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1003698507) · Data from the CMS NPPES public registry.