DR. SCOTT MATHEW PETERSON DDS, MS
NPI 1134396336
Dentist - Orthodontics and Dentofacial Orthopedics in Bloomington, IL

Active since May 15, 2008PECOS Enrolled
111 N REGENCY DR, BLOOMINGTON, IL 61701(309) 662-5331(309) 663-1112 Get Directions Write a Review

NPPES record last updated: May 15, 2008. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Dr. Scott Mathew Peterson Dds, Ms NPPES

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

DR. SCOTT MATHEW PETERSON DDS, MS (NPI 1134396336) is an individual orthodontics and dentofacial orthopedics provider in Bloomington, Illinois, licensed in Illinois (021-002109) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1134396336
Entity TypeIndividualMale
Primary Taxonomy1223X0400X
Provider Legal NameDR. SCOTT MATHEW PETERSONCredential: DDS, MS
Location Address111 N REGENCY DRBloomington, IL 61701-3515
Mailing Address111 N Regency DrBloomington, IL 61701-3515 · (309) 662-5331 · Fax (309) 663-1112
Fax(309) 663-1112
Sole ProprietorNo
Enumeration DateMay 15, 2008
NPI 1134396336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in IL · 021-002109
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
111 N REGENCY DR, Bloomington, IL 61701

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Scott Mathew Peterson Dds, Ms 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 61701 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 $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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 3

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

Dentist (Orthodontics and Dentofacial Orthopedics)
111 N REGENCY DR
BLOOMINGTON, IL 61701
Dentist (Orthodontics and Dentofacial Orthopedics)
111 N REGENCY DR
BLOOMINGTON, IL 61701
Dentist (Orthodontics and Dentofacial Orthopedics)
111 N REGENCY DR
BLOOMINGTON, IL 61701

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 Scott Peterson's NPI number?

The NPI number for Scott Peterson is 1134396336. It was assigned to this individual provider in the NPPES registry on May 15, 2008.

Where is Scott Peterson located?

Scott Peterson practices at 111 N Regency Dr, Bloomington, IL 61701. The listed phone number is (309) 662-5331.

What is Scott Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

Is Scott Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Scott Peterson was last updated on May 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.