ERIK DOUGLAS PETERSON M.D.
NPI 1437123320
Orthopaedic Surgery in Tea, SD
About Erik Douglas Peterson M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ERIK DOUGLAS PETERSON M.D. (NPI 1437123320) is an individual orthopaedic surgery provider in Tea, South Dakota, licensed in South Dakota (7258) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Sanford Tracy Medical Center, and is a graduate of Sanford School Of Medicine Of University Of South Dakota (2002).
NPPES Registry Identity
Specialties & Licenses
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS Enrollment Status
Erik Peterson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Erik Peterson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6406956689
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20080717000015, I20080814000258
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Mri scan of arm joint without contrast
Mri scan of leg joint without contrast
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
Partial removal of collar bone at shoulder using an endoscope
Prosthetic repair of shoulder joint, total shoulder
Release of tendon connecting biceps muscle and shoulder using an endoscope
Repair of shoulder rotator cuff using an endoscope
Replacement of knee joint, both sides of knee
Replacement of thigh bone and hip joint with prosthesis
Shaving of part of shoulder bone and repair of ligament using an endoscope
X-ray of both hips, 3-4 views
X-ray of hip, 2-3 views
X-ray of knee, 1-2 views
X-ray of knee, 3 views
X-ray of knee, 4 or more views
X-ray of lower and sacral spine, minimum of 4 views
X-ray of shoulder, minimum of 2 views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 142 times for 115 patientsThis 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.
This service was performed 190 times for 146 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 39 times for 39 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 41 times for 39 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 1,208 times for 107 patientsAn MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.
This service was performed 12 times for 11 patientsAn MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.
This service was performed 18 times for 17 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 51 times for 51 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 27 times for 27 patientsThis procedure involves the partial removal of the collar bone at the shoulder using an endoscope, a tool with a light and camera. It's done to relieve pain or improve shoulder movement. The surgeon makes small incisions, then uses the endoscope to guide their work.
This service was performed 16 times for 16 patientsTotal shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.
This service was performed 20 times for 19 patientsThis procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.
This service was performed 19 times for 19 patientsThis procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.
This service was performed 16 times for 16 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 38 times for 35 patientsThis procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.
This service was performed 22 times for 21 patientsThis procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.
This service was performed 21 times for 21 patientsAn X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.
This service was performed 11 times for 11 patientsAn X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
This service was performed 90 times for 69 patientsAn X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.
This service was performed 16 times for 16 patientsAn X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
This service was performed 74 times for 55 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 92 times for 76 patientsAn X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
This service was performed 19 times for 19 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 110 times for 77 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.3 for a new patient copayment and $17.3 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 57064 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.21
- Minimum New Patient Price $55.52
- Maximum New Patient Price $167.23
- Average New Patient Copayment $21.3
- Minimum New Patient Copayment $13.88
- Maximum New Patient Copayment $41.8
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $69.2
- Minimum Established Patient Price $18.08
- Maximum Established Patient Price $137.08
- Average Established Patient Copayment $17.3
- Minimum Established Patient Copayment $4.52
- Maximum Established Patient Copayment $34.27
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75.28, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: .
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 75.28 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 82.65
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category comprises 40% of a provider's final MIPS score.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 99
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category comprises 25% of a provider's final MIPS score.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: 35.78
The Cost performance category assesses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category comprises 20% of a provider's final MIPS score.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Advance Care Plan | 98% | 387 |
| Closing the Referral Loop: Receipt of Specialist Report | 53% | 491 |
| Documentation of Current Medications in the Medical Record | 100% | 1331 |
| e-Prescribing | 97% | 192 |
| Falls: Screening for Future Fall Risk | 95% | 372 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 90% | 1024 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 98% | 713 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 97% | 100 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 99% | 713 |
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 80% | 259 |
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 80% | 259 |
| Provide Patients Electronic Access to Their Health Information | 82% | 736 |
| Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS) | 0.03% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Erik Peterson is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| SANFORD TRACY MEDICAL CENTER | 251 FIFTH STREET EAST TRACY, MN 56175 | (507) 629-8400 | Critical Access Hospitals | |
| AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER | 1325 S CLIFF AVE SIOUX FALLS, SD 57117 | (605) 322-8000 | Acute Care Hospitals | |
| SIOUX FALLS SPECIALTY HOSPITAL | 910 EAST 20TH STREET SIOUX FALLS, SD 57105 | (605) 334-6730 | Acute Care Hospitals | |
| FREEMAN MEDICAL CENTER - CAH | 510 E 8TH ST POST OFFICE BOX 370 FREEMAN, SD 57029 | (605) 925-4000 | Critical Access Hospitals | |
| HURON REGIONAL MEDICAL CENTER | 172 FOURTH STREET SE HURON, SD 57350 | (605) 353-6200 | Critical Access Hospitals |
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
TEA, SD 57064
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1437123320, enumerated as an "individual" on February 15, 2006.
The provider is located at 2120 LIVE STRONGER ST TEA, SD 57064 and the phone number is (605) 331-5890.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.
Erik Peterson is affiliated with: SANFORD TRACY MEDICAL CENTER, AVERA MCKENNAN HOSPITAL & UNIVERSITY HEALTH CENTER, SIOUX FALLS SPECIALTY HOSPITAL, FREEMAN MEDICAL CENTER - CAH and HURON REGIONAL MEDICAL CENTER.
