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MITCHELL ALAN PETERSON MD
NPI 1629489596
Pediatrics in South Jordan, UT

Active since May 14, 2014PECOS Enrolled
1268 W SOUTH JORDAN PKWY STE 201, SOUTH JORDAN, UT 84095(801) 254-9700 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Aug 3, 2017 (3 updates tracked since 2017).

About Mitchell Alan Peterson Md NPPES

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

MITCHELL ALAN PETERSON MD (NPI 1629489596) is an individual pediatrics provider in South Jordan, Utah, licensed in Utah (9529304-1205) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Salt Lake City.

NPPES Registry Identity

NPI1629489596
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMITCHELL ALAN PETERSONCredential: MD
Location Address1268 W SOUTH JORDAN PKWY STE 201South Jordan, UT 84095-4653
Mailing Address1268 W South Jordan Pkwy Ste 201South Jordan, UT 84095-4653 · (801) 254-9700
Phone(801) 254-9700
Sole ProprietorNo
Enumeration DateMay 14, 2014
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1629489596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in UT · 9529304-1205
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1268 W SOUTH JORDAN PKWY STE 201, South Jordan, UT 84095
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Secondary Practice Location 1

Location 1100 Mario Capecchi DrSalt Lake City, UT 84113-1103 · Phone (801) 662-5700

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah 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 (PECOS)

Mitchell Alan Peterson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 84095 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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 4

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

LINDSI MCCOARD ROUNDY M.D.
Pediatrics
1268 W SOUTH JORDAN PKWY STE 201
SOUTH JORDAN, UT 84095
Salt Lake County (801) 254-9700
KODY R CROWELL
Pediatrics
1268 W SOUTH JORDAN PKWY STE 201, #201
SOUTH JORDAN, UT 84095
Salt Lake County (801) 254-9700
MS. CAMILLE GOFF PNP
Nurse Practitioner (Pediatrics)
1268 W SOUTH JORDAN PKWY STE 201
SOUTH JORDAN, UT 84095
Salt Lake County (801) 254-9700
DR. BRIAN PIERCE GOOD M.D.
Pediatrics
1268 W SOUTH JORDAN PKWY STE 201
SOUTH JORDAN, UT 84095
Salt Lake County (801) 254-9700

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 Mitchell Peterson's NPI number?

The NPI number for Mitchell Peterson is 1629489596. It was assigned to this individual provider in the NPPES registry on May 14, 2014.

Where is Mitchell Peterson located?

Mitchell Peterson practices at 1268 W South Jordan Pkwy Ste 201, South Jordan, UT 84095. The listed phone number is (801) 254-9700.

What is Mitchell Peterson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mitchell Peterson enrolled in Medicare?

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

What insurance does Mitchell Peterson accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Mitchell 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 Mitchell Peterson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.