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JENNIFER C PETERSON M.D.
NPI 1154586071
Pediatrics - Pediatric Critical Care Medicine in Flagstaff, AZ

Active since July 21, 2008PECOS Enrolled
1200 N BEAVER ST, FLAGSTAFF, AZ 86001(928) 213-6235 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 6, 2025, Jun 24, 2025, Jul 1, 2024 and 2 more (5 updates tracked since 2016).

About Jennifer C Peterson M.d. NPPES

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

JENNIFER C PETERSON M.D. (NPI 1154586071) is an individual pediatric critical care medicine provider in Flagstaff, Arizona, licensed in Arizona (71077) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1154586071
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameJENNIFER C PETERSONCredential: M.D.
Location Address1200 N BEAVER STFlagstaff, AZ 86001-3118
Mailing Address1836 South AveLa Crosse, WI 54601-5429 · (608) 782-7300
Phone(928) 213-6235
Sole ProprietorNo
Enumeration DateJuly 21, 2008
Last NPPES UpdateAugust 6, 20255 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
✔ NPI 1154586071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
Licenses✔ Licensed in AZ · 71077✔ Licensed in GA · 075484✔ Licensed in WI · 53734✔ Licensed in ND · 13205
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedHospitalistTaxonomy 208M00000X · License 71077 (AZ)
1200 N BEAVER ST, Flagstaff, AZ 86001
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Other Names 1

Former Name (1)Jennifer C Mosher M.d.

Secondary Practice Locations 3

Location 19003 E Shea BlvdScottsdale, AZ 85260-6709 · Phone (970) 222-0233
Location 21836 South AveLA Crosse, WI 54601-5429 · Phone (608) 782-7300
Location 31919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-1000

Other Identifiers 1

Medicaid81315ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer C Peterson M.d. 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.

Medicare Billing Reassignments

4

Medicare enrollment records show Jennifer Peterson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northern Arizona Healthcare Corporation
Same address
Family Medicine
1200 N. BEAVER STREET, ATTN: PAYER CREDENTIALING
Flagstaff, AZ 86001
  • Reassigned Medicare billing, Arizona enrollment
  • 552 clinicians in this Medicare group
NPI 1669914552 (928) 773-2546
Phoenix Children's Medical Group
110 mi
Multi-Specialty
20325 N 51ST AVE, STE 116
Glendale, AZ 85308
  • Reassigned Medicare billing, Arizona enrollment
  • Medicare enrollment name: Phoenix Children's Hospital
  • 1,416 clinicians in this Medicare group
NPI 1679703441 (602) 933-0003
Banner Physician Super Specialists Arizona LLC
114 mi
Nutrition, Education
5310 W THUNDERBIRD RD STE 214
Glendale, AZ 85306
  • Reassigned Medicare billing, Arizona enrollment
  • 188 clinicians in this Medicare group
NPI 1578125738 (602) 865-4480
Gundersen Lutheran Medical Center, Inc
1,236 mi
Clinic/Center
1836 SOUTH AVE
La Crosse, WI 54601
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,457 clinicians in this Medicare group
NPI 1689918377 (608) 782-7300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. JEREMY NIELSEN M.D.
Anesthesiology
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 779-3366
DR. SEAN DANIEL WOODS M.D.
Pediatrics (Neonatal-Perinatal Medicine)
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 773-2112
ELIZABETH GILMORE CRNA
Nurse Anesthetist, Certified Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 779-3366
TANYA LEE MORGAN TWEED RDN
Dietitian, Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 773-2441
THOMAS MATTHEW REEVE MD
Emergency Medicine
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (210) 464-7442
MS. SUSAN POMEROY BASSETT M.S.
Audiologist
1200 N BEAVER ST, AUDIOLOGY DEPARTMENT
FLAGSTAFF, AZ 86001
Coconino County (928) 214-3728
DR. ALI I RAJA MD, MSC
Neurological Surgery
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 779-3366
LEAH MARIE COFFMAN PAUL CRNA
Nurse Anesthetist, Certified Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Coconino County (928) 779-3366

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 Jennifer Peterson's NPI number?

The NPI number for Jennifer Peterson is 1154586071. It was assigned to this individual provider in the NPPES registry on July 21, 2008. The provider is also known as Jennifer C Mosher M.D..

Where is Jennifer Peterson located?

Jennifer Peterson practices at 1200 N Beaver St, Flagstaff, AZ 86001. The listed phone number is (928) 213-6235.

What is Jennifer Peterson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Jennifer Peterson enrolled in Medicare?

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

Which organizations bill Medicare for Jennifer Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Peterson reassigns Medicare benefits to 4 organizations: Northern Arizona Healthcare Corporation (Flagstaff, AZ), Phoenix Children's Medical Group (Glendale, AZ), Banner Physician Super Specialists Arizona LLC (Glendale, AZ) and Gundersen Lutheran Medical Center, Inc (La Crosse, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Peterson accept?

Health plans from Blue Cross Blue Shield of Arizona list Jennifer 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 Jennifer Peterson was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.