TIMOTHY A PETERSON MD
NPI 1134211568
Preventive Medicine - Addiction Medicine in Grand Forks, ND

Quality Rating: 75 out of 100 score

NPI Status: Active since September 30, 2006

Contact Information

3674 S WASHINGTON ST
GRAND FORKS, ND
ZIP 58201
Phone: (701) 205-3000
Fax: (701) 732-2501

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Table of Contents

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 34
Preventive Medicine
Addiction Medicine
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About TIMOTHY PETERSON

This page provides the complete NPI Profile along with additional information for Timothy Peterson, a provider established in Grand Forks, North Dakota with a medical specialization in Preventive Medicine, focusing in addiction medicine and more than 34 years of experience. The healthcare provider is registered in the NPI registry with number 1134211568 assigned on September 2006. The practitioner's primary taxonomy code is 2083A0300X with license number 7777 (ND). The provider is registered as an individual and his NPI record was last updated April 2026.

NPI: 1134211568
Provider Name: TIMOTHY A PETERSON MD
Gender: Male
Entity Type: Individual
Location Address: 3674 S WASHINGTON ST GRAND FORKS, ND 58201
Location Phone: (701) 205-3000
Location Fax: (701) 732-2501
Mailing Address: PO BOX 5210 GRAND FORKS, ND 58206
Mailing Phone: (701) 205-3000
Mailing Fax: (701) 732-2501
Medical School Name: OTHER
Graduation Year: 1992
Is Sole Proprietor?: No
Enumeration Date: 09-30-2006
Last Update Date: 04-13-2026
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Location Map

Secondary Locations

508 Upland St
Kenai, AK 99611
(907) 335-7500
206 W Rockwell Ave
Soldotna, AK 99669
(907) 335-7500

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Preventive Medicine Addiction Medicine
Taxonomy Code: 2083A0300X
Type: Allopathic & Osteopathic Physicians
License No.: 7777
License State: ND
Taxonomy Description: A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine	7777 (ND)
2	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology Psychiatry	7777 (ND)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Avera Health Plans

ConnectPlus $0 Gold - PPO
ConnectPlus $0 Silver - PPO
ConnectPlus $10,600 HSA Eligible HDHP - PPO
ConnectPlus $1800 - PPO
ConnectPlus $4500 - PPO
ConnectPlus $6500 HSA Eligible HDHP - PPO
ConnectPlus $7500 HSA Eligible HDHP - PPO
ConnectPlus MyWeighForward $2000 - PPO
ConnectPlus MyWeighForward $6000 - PPO
ConnectPlus Standard $2000 - PPO
ConnectPlus Standard $6000 - PPO
ConnectPlus Standard $7500 HSA Eligible HDHP - PPO

Blue Cross and Blue Shield of Montana

Blue Preferred Bronze PPO? 201 - PPO
Blue Preferred Bronze PPO? 202 - PPO
Blue Preferred Bronze PPO? Standard - PPO
Blue Preferred Gold PPO? 204 - PPO
Blue Preferred Gold PPO? 901 - PPO
Blue Preferred Gold PPO? Standard - PPO
Blue Preferred Security PPO? 200 - PPO
Blue Preferred Silver PPO? 203 - PPO
Blue Preferred Silver PPO? 308 - PPO
Blue Preferred Silver PPO? Standard - PPO

Blue Cross Blue Shield of North Dakota

BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO

HealthPartners

Atlas $1,300 Gold - PPO
Atlas $2,000 Standard Gold - PPO
Atlas $3,050 Plus Silver - PPO
Atlas $3,800 HSA Silver - PPO
Atlas $6,000 Standard Silver - PPO
Atlas $6,800 Plus Bronze HSA - PPO
Atlas $7,500 Standard Bronze HSA - PPO
Atlas $8,400 HSA Bronze - PPO

Medica

Altru Prime by Medica Bronze $0 Copay PCP Visits - HMO
Altru Prime by Medica Bronze Share - HMO
Altru Prime by Medica Expanded Bronze Standard - HMO
Altru Prime by Medica Gold $0 Copay PCP Visits - HMO
Altru Prime by Medica Gold Share - HMO
Altru Prime by Medica Gold Standard - HMO
Altru Prime by Medica Silver $0 Copay PCP Visits - HMO
Altru Prime by Medica Silver Share - HMO
Altru Prime by Medica Silver Standard - HMO
Essentia Choice Care with Medica Bronze $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Bronze Share - HMO
Essentia Choice Care with Medica Expanded Bronze Standard - HMO
Essentia Choice Care with Medica Gold $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Gold Share - HMO
Essentia Choice Care with Medica Gold Standard - HMO
Essentia Choice Care with Medica Silver $0 Copay PCP Visits - HMO
Essentia Choice Care with Medica Silver Share - HMO
Essentia Choice Care with Medica Silver Standard - HMO
Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
Medica Individual Choice Bronze Share - HMO

Moda Health Plan, Inc.

Moda Select Alaska Bronze 6500 - PPO
Moda Select Alaska Bronze HDHP 5500 - PPO
Moda Select Alaska Gold 1500 - PPO
Moda Select Alaska Silver 4500 - PPO
Moda Select Alaska Standard Bronze - PPO
Moda Select Alaska Standard Gold - PPO
Moda Select Alaska Standard Silver - PPO

Mountain Health CO-OP

Peak PPO Bronze HDHP - PPO
Peak PPO Bronze Standard - PPO
Peak PPO Catastrophic - PPO
Peak PPO Gold - PPO
Peak PPO Gold Standard - PPO
Peak PPO Silver - PPO
Peak PPO Silver Standard - PPO
Plus Bronze - PPO
Plus Bronze Standard - PPO
Plus Gold - PPO
Plus Gold Standard - PPO
Plus Silver Standard - PPO
PEAK PPO BRONZE - PPO
PEAK PPO BRONZE HDHP - PPO
PEAK PPO GOLD - PPO
PEAK PPO GOLD HDHP - PPO
PEAK PPO SILVER - PPO
PEAK PPO SILVER HDHP - PPO
Plus Bronze HDHP - PPO
Plus Gold HDHP - PPO

Providence Health Plan

Connect 1500 Gold - EPO
Connect 6000 Silver - EPO
Connect 9800 Bronze - EPO
HSA Qualified 7500 Bronze - Choice Network - EPO
HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Choice Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Choice Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Choice Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

Sanford Health Plan

Sanford Individual Simplicity $1,750 - PPO
Sanford Individual Simplicity $10,600 - PPO
Sanford Individual Simplicity $3,500 - PPO
Sanford Individual Simplicity $4,750 - PPO
Sanford Individual Simplicity $6,500 - PPO
Sanford Individual Simplicity $7,200 HSA Qualified - PPO
Sanford Individual Simplicity Standardized $2,000 - PPO
Sanford Individual Simplicity Standardized $6,000 - PPO
Sanford Individual Simplicity Standardized $7,500 - PPO

Select Health

Med Benchmark Expanded Bronze Select Copay Plan - HMO
Med Benchmark Expanded Bronze Standardized Plan - HMO
Med Benchmark Gold Standardized Plan - HMO
Med Benchmark Platinum - HMO
Med Benchmark Platinum Standardized Plan - HMO
Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
Med Benchmark Silver Standardized Plan - HMO
Med Gold 1500 Medical Deductible - HMO
Value Benchmark Expanded Bronze Select Copay Plan - HMO
Value Benchmark Gold Standardized Plan - HMO
Value Benchmark Platinum - HMO
Value Benchmark Platinum Standardized Plan - HMO
Value Benchmark Silver 5900 Medical Deductible - HMO
Value Benchmark Silver Standardized Plan - HMO
Value Expanded Bronze 6900 Medical Deductible - HMO
Value Gold 1500 Medical Deductible - HMO
Value Silver 3000 Medical Deductible - HMO

University of Utah Health Plans

Healthy Premier Bronze HSA - EPO
Healthy Premier Expanded Bronze Standard - EPO
Healthy Premier Gold Copay Office Visits - EPO
Healthy Premier Gold Standard - EPO
Healthy Premier Silver Copay Office Visits - EPO
Healthy Premier Silver Standard - EPO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
1694259	MEDICAID (05)	AK
1456145	MEDICAID (05)	ND

Medicare Participation & PECOS Enrollment Status

Timothy Peterson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Timothy Peterson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 9739197567
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20060405000101, I20130731000600, I20191003002801, I20200317000393, I20230816002430, I20240617003833, I20251201001976
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Assessment of emotional or behavioral problems
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Telehealth originating site facility fee

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.86 for a new patient copayment and $24.57 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 58201 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $127.45
Minimum New Patient Price $55.75
Maximum New Patient Price $168.12

Average New Patient Copayment $31.86
Minimum New Patient Copayment $13.93
Maximum New Patient Copayment $42.03

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $98.29
Minimum Established Patient Price $18.11
Maximum Established Patient Price $137.65

Average Established Patient Copayment $24.57
Minimum Established Patient Copayment $4.52
Maximum Established Patient Copayment $34.41

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

Final Score: 75 out of 100

The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
Quality Score: N/A

The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability Score: N/A

The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities Score: N/A

The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Depression screening	Yes	N/A
Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions.
Use of telehealth services that expand practice access	Yes	N/A
Use of telehealth services and analysis of data for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots that assess ability to still deliver quality care to patients.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134211568, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 2

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 4 + 1 + 2 + 5 + 1 + 2 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1134211568.