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NATHAN MICHAEL PETERSON DDS
NPI 1114596673
Dentist - General Practice in Twin Falls, ID

Active since June 20, 2021PECOS Enrolled
2174 CANYON PLAZA DR STE 100, TWIN FALLS, ID 83301(208) 735-1415 Get Directions Write a Review

NPPES record last updated: May 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 7, 2023, Jun 20, 2021 (2 updates tracked since 2021).

About Nathan Michael Peterson Dds NPPES

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

NATHAN MICHAEL PETERSON DDS (NPI 1114596673) is an individual general practice provider in Twin Falls, Idaho, licensed in Idaho (D-5290) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114596673
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameNATHAN MICHAEL PETERSONCredential: DDS
Location Address2174 CANYON PLAZA DR STE 100Twin Falls, ID 83301-4513
Mailing Address3842 Susan Cir EHansen, ID 83334-5502 · (801) 875-1560
Phone(208) 735-1415
Sole ProprietorNo
Enumeration DateJune 20, 2021
Last NPPES UpdateMay 4, 20252 updates tracked since enumeration
NPPES CertifiedMay 4, 2025
✔ NPI 1114596673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in ID · D-5290
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.
2174 CANYON PLAZA DR STE 100, Twin Falls, ID 83301
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Humana, Renaissance Dental.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nathan Michael Peterson 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83301 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
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 Nathan Peterson's NPI number?

The NPI number for Nathan Peterson is 1114596673. It was assigned to this individual provider in the NPPES registry on June 20, 2021.

Where is Nathan Peterson located?

Nathan Peterson practices at 2174 Canyon Plaza Dr Ste 100, Twin Falls, ID 83301. The listed phone number is (208) 735-1415.

What is Nathan Peterson's specialty?

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

Is Nathan Peterson enrolled in Medicare?

Yes. Nathan Peterson is registered in the Medicare PECOS enrollment system.

What insurance does Nathan Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield, Humana and Renaissance Dental list Nathan Peterson 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.

When was this NPI record last updated?

The NPPES record for Nathan Peterson was last updated on May 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.