DR. LAURIS J PETERSEN MD
NPI 1629152301
Family Medicine in Glenville, NY

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment
15 GLENRIDGE RD, GLENVILLE, NY 12302(518) 399-0909(518) 399-2640 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Lauris J Petersen Md NPPES

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

DR. LAURIS J PETERSEN MD (NPI 1629152301) is an individual family medicine provider in Glenville, New York, licensed in New York (213320) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and is a graduate of Georgetown University School Of Medicine (1995).

NPPES Registry Identity

NPI1629152301
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. LAURIS J PETERSENCredential: MD
Location Address15 GLENRIDGE RDGlenville, NY 12302-4520
Mailing Address5 Monarda DrScotia, NY 12302-4202
Fax(518) 399-2640
Sole ProprietorYes
Medical School CMSGeorgetown University School Of MedicineGraduated 1995
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1629152301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NY · 213320
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
15 GLENRIDGE RD, Glenville, NY 12302

Other Identifiers 7

OtherP00315575NY · Railroad Medicare
Other10031080NY · Cdphp
Other714547NY · Mvp
Other76V271NY · Empire Blue
Medicare UPING95418NY
Medicare ID-Type UnspecifiedRA1087NY
Other000491234003NY · Blue Shield Of Neny

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

Dr. Lauris J Petersen Md 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 ID648254995
PECOS Enrollment IDI20040617000227
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 3

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.

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
37 services18 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
15 services13 patients
Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344
A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

St Peter's Hospital

Acute Care Hospitals · Albany, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330057
Location315 South Manning BoulevardAlbany, NY 12208 · Albany County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12302 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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

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

Family Medicine
15 GLENRIDGE RD
GLENVILLE, NY 12302

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 Lauris Petersen's NPI number?

The NPI number for Lauris Petersen is 1629152301. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Lauris Petersen located?

Lauris Petersen practices at 15 Glenridge Rd, Glenville, NY 12302. The listed phone number is (518) 399-0909.

What is Lauris Petersen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lauris Petersen enrolled in Medicare?

Yes. Lauris Petersen 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.

Is Lauris Petersen affiliated with any hospitals?

According to CMS data, Lauris Petersen is affiliated with St Peter's Hospital.

When was this NPI record last updated?

The NPPES record for Lauris Petersen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.