DR. THOMAS MICHAEL PETERSON MD
NPI 1639131014
Psychiatry & Neurology - Psychiatry in Grand Forks, ND

Q: What is Thomas Peterson's NPI number?

The NPI number for Thomas Peterson is 1639131014. It was assigned to this individual provider in the NPPES registry on April 3, 2006.

Q: What is Thomas Peterson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Peterson was last updated on January 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since April 03, 2006PECOS Enrolled

4700 S WASHINGTON ST STE G, GRAND FORKS, ND 58201(701) 205-3000(701) 732-2501 Get Directions Write a Review

NPPES record last updated: January 2, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 2, 2020, May 18, 2016 (2 updates tracked since 2016).

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About Dr. Thomas Michael Peterson Md NPPES

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

DR. THOMAS MICHAEL PETERSON MD (NPI 1639131014) is an individual psychiatry provider in Grand Forks, North Dakota, licensed in North Dakota (6217) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639131014

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameDR. THOMAS MICHAEL PETERSONCredential: MD

Location Address4700 S WASHINGTON ST STE GGrand Forks, ND 58201-8123

Mailing AddressPo Box 5210Grand Forks, ND 58206-5210 · (701) 205-3000 · Fax (701) 732-2501

Phone(701) 205-3000

Fax(701) 732-2501

Sole ProprietorNo

Enumeration DateApril 3, 2006

Last NPPES UpdateJanuary 2, 20202 updates tracked since enumeration

✔ NPI 1639131014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in ND · 6217

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

4700 S WASHINGTON ST STE G, Grand Forks, ND 58201

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Other Identifiers 4

Other12325ND · Nd Bc/bs

Medicaid1460891ND

Medicaid17392ND

Medicaid878583000MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas Michael 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.

Medicare Billing Reassignments

Medicare enrollment records show Thomas Peterson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peterson Medical Clinics, LLC

0.7 mi

Multi-Specialty

3674 S WASHINGTON ST
Grand Forks, ND 58201

Reassigned Medicare billing, Alaska and Minnesota enrollments
70 clinicians in this Medicare group

NPI 1699295774 (701) 205-3000

Cowlitz Indian Tribe

1,217 mi

Rehabilitation, Substance Use Disorder

7105 NE 40TH ST
Vancouver, WA 98661

Reassigned Medicare billing, Texas enrollment
Medicare enrollment name: Bristol Bay Area Health Corporation
360 clinicians in this Medicare group

NPI 1538412630 (360) 353-9431

Norton Sound Health Corporation

2,710 mi

Critical Access

1000 GREG KRUSCHEK AVE
Nome, AK 99762

Reassigned Medicare billing, Alaska enrollment
193 clinicians in this Medicare group

NPI 1154358232 (907) 443-3311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 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

$168.12 typical visit price

range $55.75 – $168.12

Typical copayment $42.03 (range $13.93 – $42.03)

Most-billed visit code 99205

Established Patient

$69.48 typical visit price

range $18.11 – $137.65

Typical copayment $17.37 (range $4.52 – $34.41)

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 17

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

MRS. RITA DAVIS COLE LMSW

Social Worker