DR. TROY R PETERSEN DMD MD
NPI 1073697157
Dentist - Oral and Maxillofacial Surgery in Grand Forks, ND

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment
1165C SOUTH COLUMBIA ROAD, GRAND FORKS, ND 58201(701) 772-7379(701) 772-9643 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Troy R Petersen Dmd Md NPPES

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

DR. TROY R PETERSEN DMD MD (NPI 1073697157) is an individual oral and maxillofacial surgery provider in Grand Forks, North Dakota, licensed in North Dakota (1897) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Altru Hospital, and is a graduate of University Of Nebraska College Of Medicine (2001).

NPPES Registry Identity

NPI1073697157
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. TROY R PETERSENCredential: DMD MD
Location Address1165C SOUTH COLUMBIA ROADGrand Forks, ND 58201-4007
Mailing Address1165c South Columbia RoadGrand Forks, ND 58201-4007 · (701) 772-7379 · Fax (701) 772-9643
Fax(701) 772-9643
Sole ProprietorNo
Medical School CMSUniversity Of Nebraska College Of MedicineGraduated 2001
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1073697157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in ND · 1897
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1165C SOUTH COLUMBIA ROAD, Grand Forks, ND 58201

Other Identifiers 4

Medicare UPINI03250
Medicaid12975ND
Medicare ID-Type Unspecified24113ND · Bcbs Of Nd
Other252L7PEMN · Bcbs

Accepted Insurance

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

Dr. Troy R Petersen Dmd Md 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.

PECOS PAC ID3779573118
PECOS Enrollment IDI20040517000747
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152
This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
17 services16 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
17 services17 patients
Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes 99153
This service involves a physician administering medication to lower your consciousness during a procedure. It's done for your comfort and safety. The drug's effects last about 15 minutes, so additional doses may be given as needed.
16 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Altru Hospital

Acute Care Hospitals · Grand Forks, ND
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number350019
Location1200 S Columbia RdGrand Forks, ND 58201 · Grand Forks County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 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
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$69.48 typical visit price
range $18.11 – $137.65
Typical copayment $17.37 (range $4.52 – $34.41)
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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Oral and Maxillofacial Surgery)
1165C SOUTH COLUMBIA ROAD
GRAND FORKS, ND 58201

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 Troy Petersen's NPI number?

The NPI number for Troy Petersen is 1073697157. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Troy Petersen located?

Troy Petersen practices at 1165C South Columbia Road, Grand Forks, ND 58201. The listed phone number is (701) 772-7379.

What is Troy Petersen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Troy Petersen enrolled in Medicare?

Yes. Troy Petersen 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.

What insurance does Troy Petersen accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Troy Petersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Troy Petersen affiliated with any hospitals?

According to CMS data, Troy Petersen is affiliated with Altru Hospital.

When was this NPI record last updated?

The NPPES record for Troy Petersen was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.