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MICHAEL S PETERSON O.D.
NPI 1528020955
Optometrist in Salt Lake City, UT

Active since April 03, 2006PECOS EnrolledAccepts Medicare Assignment
1553 E 3080 S, SALT LAKE CITY, UT 84106(801) 879-8721 Get Directions Write a Review

NPPES record last updated: July 7, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Michael S Peterson O.d. NPPES

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

MICHAEL S PETERSON O.D. (NPI 1528020955) is an individual optometrist in Salt Lake City, Utah, licensed in Idaho (ODP100079) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2005).

NPPES Registry Identity

NPI1528020955
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameMICHAEL S PETERSONCredential: O.D.
Location Address1553 E 3080 SSalt Lake City, UT 84106-3419
Mailing Address177 W 12300 S, Ste 111Draper, UT 84020-9816 · (801) 679-9177 · Fax (801) 878-7674
Phone(801) 879-8721
Sole ProprietorYes
Medical School CMSSouthern California College Of OptometryGraduated 2005
Enumeration DateApril 3, 2006
Last NPPES UpdateJuly 7, 2014
✔ NPI 1528020955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in ID · ODP100079
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1553 E 3080 S, Salt Lake City, UT 84106
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Other Identifiers 5

OtherV6861ID · Blue Cross Of Idaho
Medicare UPINV05754
Medicaid807202700ID
Other000010151065ID · Regence Blue Shield Of Id
Medicare ID-Type Unspecified1594441ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael S Peterson O.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 ID345278131
PECOS Enrollment IDI20090612000171
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 84106 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

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 Michael Peterson's NPI number?

The NPI number for Michael Peterson is 1528020955. It was assigned to this individual provider in the NPPES registry on April 3, 2006.

Where is Michael Peterson located?

Michael Peterson practices at 1553 E 3080 S, Salt Lake City, UT 84106. The listed phone number is (801) 879-8721.

What is Michael Peterson's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Michael Peterson enrolled in Medicare?

Yes. Michael 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.

What insurance does Michael Peterson accept?

Health plans from BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Providence Health Plan, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Michael 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 Michael Peterson was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.