DR. COURTNEY PETERSON DMD
NPI 1649658691
Dentist - Pediatric Dentistry in Buffalo, NY

Q: What is Courtney Peterson's NPI number?

The NPI number for Courtney Peterson is 1649658691. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Q: What is Courtney Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Q: When was this NPI record last updated?

The NPPES record for Courtney Peterson was last updated on July 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 May 11, 2015PECOS Enrolled

462 GRIDER ST, BUFFALO, NY 14215(716) 898-1736 Get Directions Write a Review

NPPES record last updated: July 9, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Courtney Peterson Dmd NPPES

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

DR. COURTNEY PETERSON DMD (NPI 1649658691) is an individual pediatric dentistry provider in Buffalo, New York, licensed in New York (058555) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649658691

Entity TypeIndividualFemale

Primary Taxonomy1223P0221X

Provider Legal NameDR. COURTNEY PETERSONCredential: DMD

Location Address462 GRIDER STBuffalo, NY 14215-3021

Mailing Address908 Niagara Falls Blvd Ste 208North Tonawanda, NY 14120-2019 · (716) 692-3302

Phone(716) 898-1736

Sole ProprietorNo

Enumeration DateMay 11, 2015

Last NPPES UpdateJuly 9, 2019

✔ NPI 1649658691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in NY · 058555

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Also ListedDentistTaxonomy 122300000X · License 058555 (NY)

462 GRIDER ST, Buffalo, NY 14215

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.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. Courtney Peterson Dmd 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 Reassignment

Medicare enrollment records show Courtney Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Erie County Medical Center Corporation

0.1 mi

Clinic/Center

462 GRIDER ST
Buffalo, NY 14215

Reassigned Medicare billing, New York enrollment
302 clinicians in this Medicare group

NPI 1528233616 (716) 898-3000

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 14215 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

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

MR. V. THOMAS CHAPIN PMHNP

Nurse Practitioner (Psychiatric/Mental Health)

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-3000

DR. JOHN JACOB HANNIBAL IV M.D.

Student in an Organized Health Care Education/Training Program

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-4226

HMB PHARMACY MANAGEMENT LLC

Pharmacy (Community/Retail Pharmacy)

462 GRIDER ST, DRIVEWAY 3
BUFFALO, NY 14215

Erie County (716) 332-2866

SARAH MARIE THOMPSON PA-C

Physician Assistant

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 698-5375

MATTHEW GARRETT ALBEN DO

Student in an Organized Health Care Education/Training Program

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-5053

DANNY ISSAM BELMONA MD

Student in an Organized Health Care Education/Training Program

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-3000

MR. KENNETH L DZIALAK COTA

Occupational Therapy Assistant

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-3575

MS. ZENA SONDRA HYMAN NP

Nurse Practitioner (Adult Health)

462 GRIDER ST
BUFFALO, NY 14215

Erie County (716) 898-3000

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 Courtney Peterson's NPI number?

The NPI number for Courtney Peterson is 1649658691. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Courtney Peterson located?

Courtney Peterson practices at 462 Grider St, Buffalo, NY 14215. The listed phone number is (716) 898-1736.

What is Courtney Peterson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Courtney Peterson enrolled in Medicare?

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

Which organization bills Medicare for Courtney Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Courtney Peterson reassigns Medicare benefits to Erie County Medical Center Corporation (Buffalo, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Courtney Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Courtney Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Courtney 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 Courtney Peterson was last updated on July 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.