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DR. REBECCA J PETERSEN DDS
NPI 1053791954
Dentist - General Practice in Woodbury, MN

Active since June 04, 2015PECOS Enrolled
8325 SEASONS PARKWAY SUITE 103, HEALTHPARTNERS WOODBURY DENTAL, WOODBURY, MN 55125(651) 702-5848(651) 702-5870 Get Directions Write a Review

NPPES record last updated: October 30, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Rebecca J Petersen Dds NPPES

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

DR. REBECCA J PETERSEN DDS (NPI 1053791954) is an individual general practice provider in Woodbury, Minnesota, licensed in Minnesota (D13520) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053791954
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. REBECCA J PETERSENCredential: DDS
Location Address8325 SEASONS PARKWAY SUITE 103, HEALTHPARTNERS WOODBURY DENTALWoodbury, MN 55125-3477
Mailing Address8325 Seasons Parkway Suite 103, Healthpartners Woodbury DentalWoodbury, MN 55125-3477 · (651) 702-5848 · Fax (651) 702-5870
Phone(651) 702-5848
Fax(651) 702-5870
Sole ProprietorNo
Enumeration DateJune 4, 2015
Last NPPES UpdateOctober 30, 2017
✔ NPI 1053791954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · D13520
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
8325 SEASONS PARKWAY SUITE 103, Woodbury, MN 55125
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Rebecca J Petersen Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Rebecca Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Group Health, Inc.
Same address
General Practice
8325 SEASONS PKWY, STE 103
Woodbury, MN 55125
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,274 clinicians in this Medicare group
NPI 1083769335 (651) 702-5848

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 55125 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
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 Rebecca Petersen's NPI number?

The NPI number for Rebecca Petersen is 1053791954. It was assigned to this individual provider in the NPPES registry on June 4, 2015.

Where is Rebecca Petersen located?

Rebecca Petersen practices at 8325 Seasons Parkway Suite 103 Healthpartners Woodbury Dental, Woodbury, MN 55125. The listed phone number is (651) 702-5848.

What is Rebecca Petersen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Rebecca Petersen enrolled in Medicare?

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

Which organization bills Medicare for Rebecca Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rebecca Petersen reassigns Medicare benefits to Group Health, Inc. (Woodbury, MN). 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 Rebecca 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 Rebecca Petersen was last updated on October 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.