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MR. GARY M PETERSON M.D.
NPI 1699724955
Family Medicine in Duluth, MN

Active since May 06, 2006PECOS Enrolled
4702 GRAND AVE, DULUTH, MN 55807(218) 249-6800(218) 249-6808 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 4, 2020, Jan 30, 2017 (2 updates tracked since 2017).

About Mr. Gary M Peterson M.d. NPPES

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

MR. GARY M PETERSON M.D. (NPI 1699724955) is an individual family medicine provider in Duluth, Minnesota, licensed in Minnesota (28567) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699724955
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. GARY M PETERSONCredential: M.D.
Location Address4702 GRAND AVEDuluth, MN 55807-2742
Mailing Address4702 Grand AveDuluth, MN 55807-2742 · (218) 249-6800 · Fax (218) 249-6808
Phone(218) 249-6800
Fax(218) 249-6808
Sole ProprietorNo
Enumeration DateMay 6, 2006
Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration
NPPES CertifiedDecember 4, 2020
✔ NPI 1699724955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 28567
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.
4702 GRAND AVE, Duluth, MN 55807
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Other Identifiers 1

Medicaid611373700MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, Security 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)

Mr. Gary M Peterson M.d. 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 Gary Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. Luke's Hospital Of Duluth
Same address
Family Medicine
4702 GRAND AVE
Duluth, MN 55807
  • Reassigned Medicare billing, Minnesota and Wisconsin enrollments
  • Also billed through NPI 1528505955 (Wisconsin)
  • 513 clinicians in this Medicare group
NPI 1033161161 (218) 249-6800

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 55807 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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 10

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

ST. LUKE'S HOSPITAL OF DULUTH
Family Medicine
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6800
TYLER J KOBILARCSIK DPT
Physical Therapist
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-5555
MR. ERIC CHARLES ENBERG MD
Family Medicine
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6800
MR. STEVEN L. FOLTZ PA
Physician Assistant
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6822
ERICA MARIE WILLIAMS
Nurse Practitioner (Adult Health)
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6822
JENNIFER WARD CNP
Nurse Practitioner (Occupational Health)
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6822
ST. LUKE'S HOSPITAL OF DULUTH
Preventive Medicine (Occupational Medicine)
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6822
DR. NICHOLE MARIE SCHAEFER MD
Family Medicine
4702 GRAND AVE
DULUTH, MN 55807
St. Louis County (218) 249-6800

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 Gary Peterson's NPI number?

The NPI number for Gary Peterson is 1699724955. It was assigned to this individual provider in the NPPES registry on May 6, 2006.

Where is Gary Peterson located?

Gary Peterson practices at 4702 Grand Ave, Duluth, MN 55807. The listed phone number is (218) 249-6800.

What is Gary Peterson's specialty?

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

Is Gary Peterson enrolled in Medicare?

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

Which organization bills Medicare for Gary Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Peterson reassigns Medicare benefits to St. Luke's Hospital Of Duluth (Duluth, 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 Gary Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gary Peterson accept?

Health plans from Aspirus Health Plan and Security Health Plan list Gary 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 Gary Peterson was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.