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CHARLES E PETERSON MD
NPI 1326025495
Surgery - Vascular Surgery in South Bend, IN

Active since December 29, 2005PECOS Enrolled
621 MEMORIAL DR STE 502, SOUTH BEND, IN 46601(574) 647-5875(574) 647-5878 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 8, 2021, Mar 31, 2021 (2 updates tracked since 2021).

About Charles E Peterson Md NPPES

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

CHARLES E PETERSON MD (NPI 1326025495) is an individual vascular surgery provider in South Bend, Indiana, licensed in Indiana (01028400A) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Elkhart.

NPPES Registry Identity

NPI1326025495
Entity TypeIndividualMale
Primary Taxonomy2086S0129X
Provider Legal NameCHARLES E PETERSONCredential: MD
Location Address621 MEMORIAL DR STE 502South Bend, IN 46601-1075
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Phone(574) 647-5875
Fax(574) 647-5878
Sole ProprietorNo
Enumeration DateDecember 29, 2005
Last NPPES UpdateJuly 8, 20212 updates tracked since enumeration
NPPES CertifiedJuly 8, 2021
✔ NPI 1326025495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
License✔ Licensed in IN · 01028400A
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
621 MEMORIAL DR STE 502, South Bend, IN 46601
Open in Google Maps ↗

Secondary Practice Location 1

Location 1500 Arcade Ave Ste 210Elkhart, IN 46514-2485 · Phone (574) 389-5656

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles E Peterson Md 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 46601 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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 19

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

DR. ROBERT G. CREDI MD
Surgery
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
BRETT HOOKER FNP-BC
Nurse Practitioner (Family)
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
BEACON MEDICAL GROUP, INC.
Surgery (Trauma Surgery)
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
SABRINA PASLEY PA
Physician Assistant
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
DANIEL P. SRIKUREJA MD
Surgery
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
CAROLINE L WALTERS PA-C
Physician Assistant
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
GREGORY GEORGE BINGAMAN NP
Nurse Practitioner (Acute Care)
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
JOHN WALSH AG-ACNP
Nurse Practitioner (Acute Care)
621 MEMORIAL DR STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875

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 Charles Peterson's NPI number?

The NPI number for Charles Peterson is 1326025495. It was assigned to this individual provider in the NPPES registry on December 29, 2005.

Where is Charles Peterson located?

Charles Peterson practices at 621 Memorial Dr Ste 502, South Bend, IN 46601. The listed phone number is (574) 647-5875.

What is Charles Peterson's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Charles Peterson enrolled in Medicare?

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

What insurance does Charles Peterson accept?

Health plans from CareSource list Charles 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 Charles Peterson was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.