ROBIN PETERSON PSY D LLC
NPI 1053078477
Psychologist in Bettendorf, IA

Active since November 19, 2021
1035 LINCOLN RD STE 202, BETTENDORF, IA 52722(563) 355-4879 Get Directions Write a Review

NPPES record last updated: January 4, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 4, 2022, Dec 9, 2021, Nov 19, 2021 (3 updates tracked since 2021).

About Robin Peterson Psy D Llc NPPES

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

ROBIN PETERSON PSY D LLC (NPI 1053078477) is a healthcare organization registered as a psychologist in Bettendorf, Iowa and active in the NPI registry since November 2021. The organization lists Robin R Peterson, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1053078477
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameROBIN PETERSON PSY D LLC
Location Address1035 LINCOLN RD STE 202Bettendorf, IA 52722-4149
Mailing Address1035 Lincoln Rd Ste 202Bettendorf, IA 52722-4149 · (563) 355-4879
Organization SubpartNo
Authorized OfficialRobin R PetersonClinical Psychologist · (616) 920-0479
Enumeration DateNovember 19, 2021
Last NPPES UpdateJanuary 4, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2022
✔ NPI 1053078477 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1035 LINCOLN RD STE 202, Bettendorf, IA 52722

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robin Peterson Psy D Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIowaEnrollment IDO20211214002159Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Robin Peterson Psy D LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1124392477
1035 LINCOLN RD STE 202
Bettendorf, IA 52722
(563) 355-4879
✔ PECOS✔ Accepts MedicareSame address

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

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 Robin Peterson Psy D LLC's NPI number?

The NPI number for Robin Peterson Psy D LLC is 1053078477. It was assigned to this organization in the NPPES registry on November 19, 2021.

Where is Robin Peterson Psy D LLC located?

Robin Peterson Psy D LLC is located at 1035 Lincoln Rd Ste 202, Bettendorf, IA 52722. The listed phone number is (563) 355-4879.

What is Robin Peterson Psy D LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Robin Peterson Psy D LLC enrolled in Medicare?

Yes. Robin Peterson Psy D LLC is registered in the Medicare PECOS enrollment system.

When is Robin Peterson Psy D LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Iowa, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Robin Peterson Psy D LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Robin Peterson Psy D LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Robin Peterson Psy D LLC was last updated on January 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.