DR. JACOB MASON PETERS D.D.S.
NPI 1154558252
Dentist - General Practice in Rochester, MN

Q: What is Jacob Peters's NPI number?

The NPI number for Jacob Peters is 1154558252. It was assigned to this individual provider in the NPPES registry on June 16, 2009.

Q: What is Jacob Peters's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Peters was last updated on June 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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 16, 2009PECOS Enrolled

1011 BEL AIR LN NW, ROCHESTER, MN 55901(507) 288-1188(507) 529-4065 Get Directions Write a Review

NPPES record last updated: June 16, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Jacob Mason Peters D.d.s. NPPES

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

DR. JACOB MASON PETERS D.D.S. (NPI 1154558252) is an individual general practice provider in Rochester, Minnesota, licensed in Minnesota (12668) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154558252

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JACOB MASON PETERSCredential: D.D.S.

Location Address1011 BEL AIR LN NWRochester, MN 55901-6992

Mailing Address1011 Bel Air Ln NwRochester, MN 55901-6992 · (507) 288-1188 · Fax (507) 529-4065

Phone(507) 288-1188

Fax(507) 529-4065

Sole ProprietorNo

Enumeration DateJune 16, 2009

✔ NPI 1154558252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MN · 12668

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.

1011 BEL AIR LN NW, Rochester, MN 55901

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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. Jacob Mason Peters D.d.s. 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 55901 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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 9

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

TARYN BELL DDS

Dentist