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DR. DERIC WYMER PETERSON AU.D.
NPI 1659698959
Audiologist in Marshall, MN

Active since April 26, 2010
1424 E COLLEGE DR STE 200, MARSHALL, MN 56258(507) 532-2687 Get Directions Write a Review

NPPES record last updated: December 14, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Deric Wymer Peterson Au.d. NPPES

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

DR. DERIC WYMER PETERSON AU.D. (NPI 1659698959) is an individual audiologist in Marshall, Minnesota, licensed in Minnesota (8599) and active in the NPI registry since April 2010.

NPPES Registry Identity

NPI1659698959
Entity TypeIndividualMale
Primary Taxonomy231H00000X
Provider Legal NameDR. DERIC WYMER PETERSONCredential: AU.D.
Location Address1424 E COLLEGE DR STE 200Marshall, MN 56258-2087
Mailing Address1424 E College Dr Ste 200Marshall, MN 56258-2087
Phone(507) 532-2687
Sole ProprietorNo
Enumeration DateApril 26, 2010
Last NPPES UpdateDecember 14, 2011
✔ NPI 1659698959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers
Taxonomy Code231H00000X
License✔ Licensed in MN · 8599
Definition
(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
1424 E COLLEGE DR STE 200, Marshall, MN 56258
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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. Deric Wymer Peterson Au.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

Jka5 Enterprises
108 mi
Audiologist
2848 2ND ST S, 185
Saint Cloud, MN 56301
  • Reassigned Medicare billing, Minnesota enrollment
  • 3 clinicians in this Medicare group
NPI 1568869188 (320) 252-0094

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

Other Providers at the Same Location NPPES

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

DR. AMBER LANDSMAN AU.D.
Audiologist
1424 E COLLEGE DR STE 200
MARSHALL, MN 56258
Lyon County (507) 532-2687

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 Deric Peterson's NPI number?

The NPI number for Deric Peterson is 1659698959. It was assigned to this individual provider in the NPPES registry on April 26, 2010.

Where is Deric Peterson located?

Deric Peterson practices at 1424 E College Dr Ste 200, Marshall, MN 56258. The listed phone number is (507) 532-2687.

What is Deric Peterson's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is Deric Peterson enrolled in Medicare?

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

Which organization bills Medicare for Deric Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Deric Peterson reassigns Medicare benefits to Jka5 Enterprises (Saint Cloud, MN). 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 Deric Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Deric Peterson accept?

Health plans from UnitedHealthcare list Deric 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 Deric Peterson was last updated on December 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.