DR. DUSTIN J PETERSEN M.D.
NPI 1265661383
Surgery - Surgical Critical Care in Fort Wayne, IN

Q: What is Dustin Petersen's NPI number?

The NPI number for Dustin Petersen is 1265661383. It was assigned to this individual provider in the NPPES registry on July 10, 2009.

Q: What is Dustin Petersen's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Critical Care, with taxonomy code 2086S0102X.

Q: When was this NPI record last updated?

The NPPES record for Dustin Petersen was last updated on October 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 July 10, 2009PECOS EnrolledAccepts Medicare Assignment

81.23/100

CMS Quality Rating

11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845(260) 266-8900(260) 266-8935 Get Directions Write a Review

NPPES record last updated: October 10, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2022, Jul 7, 2021, Oct 17, 2016 (3 updates tracked since 2016).

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About Dr. Dustin J Petersen M.d. NPPES

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

DR. DUSTIN J PETERSEN M.D. (NPI 1265661383) is an individual surgical critical care provider in Fort Wayne, Indiana, licensed in Indiana (01073898A) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1265661383

Entity TypeIndividualMale

Primary Taxonomy2086S0102X

Provider Legal NameDR. DUSTIN J PETERSENCredential: M.D.

Location Address11141 PARKVIEW PLAZA DR STE 305Fort Wayne, IN 46845-1715

Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701

Phone(260) 266-8900

Fax(260) 266-8935

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateJuly 10, 2009

Last NPPES UpdateOctober 10, 20223 updates tracked since enumeration

NPPES CertifiedOctober 10, 2022

✔ NPI 1265661383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Surgical Critical CareAllopathic & Osteopathic Physicians

Taxonomy Code2086S0102X

Licenses✔ Licensed in IN · 01073898A✔ Licensed in WV · 26510

Definition

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedSurgeryTaxonomy 208600000X · License 26510 (WV), 01073898A (IN)

Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X · License 26510 (WV), 01073898A (IN)

11141 PARKVIEW PLAZA DR STE 305, Fort Wayne, IN 46845

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, CareSource (Common Ground Healthcare).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dustin J Petersen M.d. 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 ID547408619

PECOS Enrollment IDI20170302002444

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.

Areas of Expertise CMS Part B claims 3

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

26 services26 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

19 services18 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150017

Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County

Emergency services Birthing friendly

Dupont Hospital LLC

Acute Care Hospitals · Fort Wayne, IN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number150150

Location2520 E Dupont RdFort Wayne, IN 46825 · Allen County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.23/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.95

Promoting Interoperability

100

Improvement Activities

Cost

68.49

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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. CRESSILEE BRYANT M.D.

Surgery