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DR. AMANDA LYNN PETERSON PHD LP
NPI 1508547977
Psychologist - Clinical in Rosemount, MN

Active since July 28, 2023PECOS Enrolled
15265 CARROUSEL WAY, ROSEMOUNT, MN 55068(952) 443-4600 Get Directions Write a Review

NPPES record last updated: December 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 4, 2023, Jul 28, 2023 (2 updates tracked since 2023).

About Dr. Amanda Lynn Peterson Phd Lp NPPES

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

DR. AMANDA LYNN PETERSON PHD LP (NPI 1508547977) is an individual clinical provider in Rosemount, Minnesota, licensed in Minnesota (LP7008) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1508547977
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. AMANDA LYNN PETERSONCredential: PHD LP
Location Address15265 CARROUSEL WAYRosemount, MN 55068-1760
Mailing Address15265 Carrousel WayRosemount, MN 55068-1760
Phone(952) 443-4600
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 28, 2023
Last NPPES UpdateDecember 4, 20232 updates tracked since enumeration
NPPES CertifiedDecember 4, 2023
✔ NPI 1508547977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · LP7008
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
15265 CARROUSEL WAY, Rosemount, MN 55068
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Amanda Lynn Peterson Phd Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153770284
PECOS Enrollment IDI20231214000107
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 55068 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
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
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 20

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

SAMANTHA CLINE
Student in an Organized Health Care Education/Training Program
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4604
SOAPY NGUON-SANTANA
Student in an Organized Health Care Education/Training Program
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
ASHLEY UTZ
Social Worker (Clinical)
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
ABBIE DECHAMPS
Student in an Organized Health Care Education/Training Program
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
JENNIFER J NOBOISE
Student in an Organized Health Care Education/Training Program
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
KELLY J KIVEL LPCC, LPC
Counselor (Professional)
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
HAYLEY LYDIA FERVOY
Student in an Organized Health Care Education/Training Program
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600
MS. BRITTANY DALE LEITCH JOHNSON LICSW
Social Worker (Clinical)
15265 CARROUSEL WAY
ROSEMOUNT, MN 55068
Dakota County (952) 443-4600

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 Amanda Peterson's NPI number?

The NPI number for Amanda Peterson is 1508547977. It was assigned to this individual provider in the NPPES registry on July 28, 2023.

Where is Amanda Peterson located?

Amanda Peterson practices at 15265 Carrousel Way, Rosemount, MN 55068. The listed phone number is (952) 443-4600.

What is Amanda Peterson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Amanda Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Amanda Peterson was last updated on December 4, 2023. 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.