SHANE STEAN PETERSON DO
NPI 1609439066
Radiology - Diagnostic Radiology in Orlando, FL

Q: What is Shane Peterson's NPI number?

The NPI number for Shane Peterson is 1609439066. It was assigned to this individual provider in the NPPES registry on April 20, 2019.

Q: What is Shane Peterson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Shane Peterson was last updated on September 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since April 20, 2019PECOS EnrolledAccepts Medicare Assignment

601 E ROLLINS ST, ADVENTHEALTH MEDICAL GROUP RADIOLOGY AT CENTRAL FLORIDA, ORLANDO, FL 32803(407) 200-2355 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 8, 2025, Jun 26, 2024, May 31, 2020 and 1 more (4 updates tracked since 2019).

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About Shane Stean Peterson Do NPPES

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

SHANE STEAN PETERSON DO (NPI 1609439066) is an individual diagnostic radiology provider in Orlando, Florida, licensed in Florida (OS22276) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2019).

NPPES Registry Identity

NPI1609439066

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameSHANE STEAN PETERSONCredential: DO

Location Address601 E ROLLINS ST, ADVENTHEALTH MEDICAL GROUP RADIOLOGY AT CENTRAL FLORIDAOrlando, FL 32803-1248

Mailing AddressPo Box 946414Atlanta, GA 30394-6414 · (407) 200-2355

Phone(407) 200-2355

Sole ProprietorNo

Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2019

Enumeration DateApril 20, 2019

Last NPPES UpdateSeptember 8, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 8, 2025

✔ NPI 1609439066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in FL · OS22276✔ Licensed in CT · 069426✔ Licensed in MN · 76770

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

601 E ROLLINS ST, Orlando, FL 32803

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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 and accepts Medicare assignment

Shane Stean Peterson Do 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 ID345785721

PECOS Enrollment IDI20250820004251, I20250822003257, I20260601003276

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

41 services24 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

27 services16 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100007

Location601 E Rollins StOrlando, FL 32803 · Orange County

Emergency services Birthing friendly

Adventhealth New Smyrna Beach

Acute Care Hospitals · New Smyrna Beach, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100014

Location401 Palmetto StNew Smyrna Beach, FL 32170 · Volusia County

Emergency services

Adventhealth Deland

Acute Care Hospitals · Deland, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100045

Location701 W Plymouth AveDeland, FL 32720 · Volusia County

Emergency services

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100057

Location1000 Waterman WayTavares, FL 32778 · Lake County

Birthing friendly

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100068

Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32803 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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 20

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

MRS. ELIZABETH BONET CNM

Advanced Practice Midwife