DR. DYLAN BERNS PETERSON MD
NPI 1083134019
Family Medicine in Tacoma, WA

Q: What is Dylan Peterson's NPI number?

The NPI number for Dylan Peterson is 1083134019. It was assigned to this individual provider in the NPPES registry on June 21, 2017.

Q: What is Dylan Peterson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Dylan Peterson was last updated on June 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 21, 2017PECOS EnrolledAccepts Medicare Assignment

1708 E 44TH ST, TACOMA, WA 98404(253) 722-2161 Get Directions Write a Review

NPPES record last updated: June 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 29, 2021, Apr 4, 2020, Jun 16, 2018 and 1 more (4 updates tracked since 2017).

On this page

About Dr. Dylan Berns Peterson Md NPPES

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

DR. DYLAN BERNS PETERSON MD (NPI 1083134019) is an individual family medicine provider in Tacoma, Washington, licensed in Washington (MD61181360) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with St Joseph Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1083134019

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. DYLAN BERNS PETERSONCredential: MD

Location Address1708 E 44TH STTacoma, WA 98404-4611

Mailing Address1148 Broadway Ste 100Tacoma, WA 98402-3518 · (253) 722-1539

Phone(253) 722-2161

Sole ProprietorNo

Medical School CMSUniversity Of Maryland School Of MedicineGraduated 2017

Enumeration DateJune 21, 2017

Last NPPES UpdateJune 29, 20214 updates tracked since enumeration

NPPES CertifiedJune 29, 2021

✔ NPI 1083134019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WA · MD61181360✔ Licensed in RI · MD17011✔ Licensed in RI · LP04110

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1708 E 44TH ST, Tacoma, WA 98404

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1111 Brewster St, FCC CPawtucket, RI 02860 · Phone (401) 729-2769 · Fax (401) 729-2772

Location 2450 Clinton StWoonsocket, RI 02895-3207 · Phone (401) 767-4100 · Fax (401) 235-6896

Other Identifiers 1

OtherLP04110RI · Rhode Island State Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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. Dylan Berns Peterson 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 ID143644674

PECOS Enrollment IDI20211011000348

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.

Hospital Affiliations CMS Care Compare

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

St Joseph Medical Center

Acute Care Hospitals · Tacoma, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number500108

Location1717 South J StreetTacoma, WA 98405 · Pierce County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98404 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

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.

MRS. JULIE ANN HILLS RN

Registered Nurse (Obstetric, High-Risk)