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STACY PETERSON M.D.
NPI 1356515704
Anesthesiology - Pain Medicine in Milwaukee, WI

Active since April 16, 2008PECOS EnrolledAccepts Medicare Assignment
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226(414) 266-3560(414) 266-6092 Get Directions Write a Review

NPPES record last updated: March 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stacy Peterson M.d. NPPES

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

STACY PETERSON M.D. (NPI 1356515704) is an individual pain medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (52973) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2007).

NPPES Registry Identity

NPI1356515704
Entity TypeIndividualFemale
Primary Taxonomy207LP2900X
Provider Legal NameSTACY PETERSONCredential: M.D.
Location Address9000 W WISCONSIN AVEMilwaukee, WI 53226-4874
Mailing Address9000 W Wisconsin AveMilwaukee, WI 53226-4874 · (414) 266-3560 · Fax (414) 266-6092
Phone(414) 266-3560
Fax(414) 266-6092
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2007
Enumeration DateApril 16, 2008
Last NPPES UpdateMarch 13, 2024
NPPES CertifiedMarch 13, 2024
✔ NPI 1356515704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207LP2900X
License✔ Licensed in WI · 52973
Definition
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
Also ListedAnesthesiologyTaxonomy 207L00000X · License 52973 (WI)
9000 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1959 N Mayfair Rd, MCW PAIN MANAGEMENT CENTERMilwaukee, WI 53226-3465 · Phone (414) 955-7601 · Fax (414) 955-6020
Location 29200 W Wisconsin AveMilwaukee, WI 53226-3522 · Phone (414) 805-8700 · Fax (414) 259-1522

Other Identifiers 1

Medicaid1356515704WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.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

Stacy Peterson 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 ID8729238324
PECOS Enrollment IDI20121016000699
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

3

Medicare enrollment records show Stacy Peterson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Specialty Group, Inc.
Same address
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
The Medical College Of Wisconsin, Inc.
0.1 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101
Froedtert & the Medical College Of Wisconsin Community Physicians, Inc.
10 mi
Internal Medicine
W180N8000 TOWN HALL RD
Menomonee Falls, WI 53051
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,294 clinicians in this Medicare group
NPI 1568787448 (262) 255-2500

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.

MS. LESLIE L. TALBERT NP
Nurse Practitioner (Pediatrics)
9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-3360
SARAH MARIE RUMLER DO
Pediatrics (Pediatric Hematology-Oncology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-4170
ALISON COREN
Pediatrics (Pediatric Endocrinology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6750
BRANDON PALMER M.D.
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 337-7050
AIDAN JAMES REID DO
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6800
KYNDAL LYN HETTICH RD, CSP, CD
Dietitian, Registered
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-5938
CARISA MARIE DIMATTINA LCSW
Social Worker (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 581-4004
BREYA LOGAN WHITEFIELD PHD
Psychologist (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-2000

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 Stacy Peterson's NPI number?

The NPI number for Stacy Peterson is 1356515704. It was assigned to this individual provider in the NPPES registry on April 16, 2008.

Where is Stacy Peterson located?

Stacy Peterson practices at 9000 W Wisconsin Ave, Milwaukee, WI 53226. The listed phone number is (414) 266-3560.

What is Stacy Peterson's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Is Stacy Peterson enrolled in Medicare?

Yes. Stacy Peterson 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 organizations bill Medicare for Stacy Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Peterson reassigns Medicare benefits to 3 organizations: Children's Specialty Group, Inc. (Milwaukee, WI), The Medical College Of Wisconsin, Inc. (Milwaukee, WI) and Froedtert & the Medical College Of Wisconsin Community Physicians, Inc. (Menomonee Falls, 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 Stacy Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stacy Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and Network Health list Stacy 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 Stacy Peterson was last updated on March 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.