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JAMES PETERSON DDS
NPI 1376806224
Dentist - General Practice in Springfield, IL

Active since June 15, 2012PECOS Enrolled
2501 W ILES AVE STE A, SPRINGFIELD, IL 62704(217) 452-3057 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About James Peterson Dds NPPES

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

JAMES PETERSON DDS (NPI 1376806224) is an individual general practice provider in Springfield, Illinois, licensed in Illinois (019029045) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376806224
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJAMES PETERSONCredential: DDS
Location Address2501 W ILES AVE STE ASpringfield, IL 62704-6482
Mailing Address2501 W Iles Ave Ste ASpringfield, IL 62704-6482 · (217) 452-3057
Phone(217) 452-3057
Sole ProprietorNo
Enumeration DateJune 15, 2012
Last NPPES UpdateMarch 4, 2025
NPPES CertifiedMarch 4, 2025
✔ NPI 1376806224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IL · 019029045
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedDentist · Dental Public HealthTaxonomy 1223D0001X · License 019029045 (IL)
2501 W ILES AVE STE A, Springfield, IL 62704
Open in Google Maps ↗

Other Identifiers 1

Other019029045IL · Illinois License Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

James Peterson Dds 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 62704 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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

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

PETERSON DENTAL CARE LLC
Clinic/Center (Dental)
2501 W ILES AVE STE A
SPRINGFIELD, IL 62704
Sangamon County (217) 787-4015

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 James Peterson's NPI number?

The NPI number for James Peterson is 1376806224. It was assigned to this individual provider in the NPPES registry on June 15, 2012.

Where is James Peterson located?

James Peterson practices at 2501 W Iles Ave Ste A, Springfield, IL 62704. The listed phone number is (217) 452-3057.

What is James Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is James Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for James Peterson was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.