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LIDIA TIMOFEENKO PETERSEN
NPI 1245857952
Nurse Practitioner - Psychiatric/Mental Health in Las Vegas, NV

Active since June 29, 2020PECOS EnrolledAccepts Medicare Assignment
972 SUGAR SPRINGS DR, LAS VEGAS, NV 89110(208) 410-3048 Get Directions Write a Review

NPPES record last updated: September 6, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 6, 2022, Jun 29, 2020 (2 updates tracked since 2020).

About Lidia Timofeenko Petersen NPPES

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

LIDIA TIMOFEENKO PETERSEN (NPI 1245857952) is an individual psychiatric/mental health provider in Las Vegas, Nevada, licensed in Nevada (835379) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1245857952
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameLIDIA TIMOFEENKO PETERSEN
Location Address972 SUGAR SPRINGS DRLas Vegas, NV 89110-2936
Mailing Address972 Sugar Springs DrLas Vegas, NV 89110-2936 · (208) 410-3048
Phone(208) 410-3048
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateJune 29, 2020
Last NPPES UpdateSeptember 6, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2022
✔ NPI 1245857952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in NV · 835379✔ Licensed in ID · 53260✔ Licensed in ID · TEMP53260
972 SUGAR SPRINGS DR, Las Vegas, NV 89110
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lidia Timofeenko Petersen is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769895960
PECOS Enrollment IDI20221011002765
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 Reassignment

Medicare enrollment records show Lidia Timofeenko Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern Nevada Adult Mental Health
12 mi
Adult Mental Health
6161 W CHARLESTON BLVD
Las Vegas, NV 89146
  • Reassigned Medicare billing, Nevada enrollment
  • Medicare enrollment name: State Of Nevada
  • 143 clinicians in this Medicare group
NPI 1891756920 (702) 486-6000

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
166 services59 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89110 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
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
Most-billed visit code 99214
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 Lidia Timofeenko Petersen's NPI number?

The NPI number for Lidia Timofeenko Petersen is 1245857952. It was assigned to this individual provider in the NPPES registry on June 29, 2020.

Where is Lidia Timofeenko Petersen located?

Lidia Timofeenko Petersen practices at 972 Sugar Springs Dr, Las Vegas, NV 89110. The listed phone number is (208) 410-3048.

What is Lidia Timofeenko Petersen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Lidia Timofeenko Petersen enrolled in Medicare?

Yes. Lidia Timofeenko Petersen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Lidia Timofeenko Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lidia Timofeenko Petersen reassigns Medicare benefits to Southern Nevada Adult Mental Health (Las Vegas, NV). The 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 Lidia Timofeenko Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lidia Timofeenko Petersen accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Lidia Timofeenko Petersen 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 Lidia Timofeenko Petersen was last updated on September 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.