DR. ELISABETH M PETERSON DDS
NPI 1508094244
Dentist - Oral and Maxillofacial Surgery in St. Paul, MN
About Dr. Elisabeth M Peterson Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ELISABETH M PETERSON DDS (NPI 1508094244) is an individual oral and maxillofacial surgery provider in St. Paul, Minnesota, licensed in Minnesota (D12105) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Elisabeth M Peterson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Elisabeth Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Saint Paul, MN 55108
- Reassigned Medicare billing, Minnesota enrollment
- 2,274 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ST PAUL, MN 55108
ST PAUL, MN 55108
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 Elisabeth Peterson's NPI number?
The NPI number for Elisabeth Peterson is 1508094244. It was assigned to this individual provider in the NPPES registry on July 1, 2009.
Where is Elisabeth Peterson located?
Elisabeth Peterson practices at 2500 Como Avenue, St. Paul, MN 55108. The listed phone number is (651) 999-4600.
What is Elisabeth Peterson's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Elisabeth Peterson enrolled in Medicare?
Yes. Elisabeth Peterson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Elisabeth Peterson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elisabeth Peterson reassigns Medicare benefits to Group Health, Inc. (Saint Paul, MN). The 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 Elisabeth Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Elisabeth Peterson was last updated on March 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Dr. Elisabeth M Peterson, DDS · NPI 1508094244
Oral and Maxillofacial Surgery provider in St. Paul, Minnesota. Individual provider, active in the CMS NPPES registry since July 1, 2009.
## Identity
- **NPI:** 1508094244 (Entity type: Individual)
- **Enumerated:** July 1, 2009
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** D12105 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2500 COMO AVENUE, St. Paul, MN 55108-1460
- **Phone:** (651) 999-4600 · **Fax:** (651) 632-8984
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Group Health, Inc. (NPI 1225629017, Saint Paul, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 30, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1508094244) · Data from the CMS NPPES public registry.