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ALEXIS GUNDERSEN PETERSEN FNP
NPI 1043029457
Nurse Practitioner - Family in Taylorsville, UT

Active since January 01, 2025PECOS Enrolled
6048 S HAZELHURST DR, TAYLORSVILLE, UT 84129(801) 560-9124 Get Directions Write a Review

NPPES record last updated: January 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 11, 2025, Jan 1, 2025 (2 updates tracked since 2025).

About Alexis Gundersen Petersen Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXIS GUNDERSEN PETERSEN FNP (NPI 1043029457) is an individual family provider in Taylorsville, Utah, licensed in Utah (9252507-4405) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1043029457
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameALEXIS GUNDERSEN PETERSENCredential: FNP
Location Address6048 S HAZELHURST DRTaylorsville, UT 84129-5108
Mailing Address6048 S Hazelhurst DrTaylorsville, UT 84129-5108
Phone(801) 560-9124
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 1, 2025
Last NPPES UpdateJanuary 11, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2025
✔ NPI 1043029457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 9252507-4405
6048 S HAZELHURST DR, Taylorsville, UT 84129
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexis Gundersen Petersen Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9537641170
PECOS Enrollment IDI20260304000229
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Alexis Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signify Health, LLC
991 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Utah enrollment
  • 145 clinicians in this Medicare group
NPI 1689158487 (469) 466-7007

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84129 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Alexis Petersen's NPI number?

The NPI number for Alexis Petersen is 1043029457. It was assigned to this individual provider in the NPPES registry on January 1, 2025.

Where is Alexis Petersen located?

Alexis Petersen practices at 6048 S Hazelhurst Dr, Taylorsville, UT 84129. The listed phone number is (801) 560-9124.

What is Alexis Petersen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Alexis Petersen enrolled in Medicare?

Yes. Alexis Petersen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alexis Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alexis Petersen reassigns Medicare benefits to Signify Health, LLC (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alexis Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alexis Petersen was last updated on January 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.