MRS. ANTONIQUE PETERSON DO
NPI 1700377124
General Practice in Minneapolis, MN
About Mrs. Antonique Peterson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. ANTONIQUE PETERSON DO (NPI 1700377124) is an individual general practice provider in Minneapolis, Minnesota, licensed in Minnesota (69440) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2018).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Antonique Peterson Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Antonique Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30309
- Reassigned Medicare billing, Georgia enrollment
- 13 clinicians in this Medicare group
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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55411
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 Antonique Peterson's NPI number?
The NPI number for Antonique Peterson is 1700377124. It was assigned to this individual provider in the NPPES registry on May 21, 2018.
Where is Antonique Peterson located?
Antonique Peterson practices at 1313 Penn Ave N, Minneapolis, MN 55411. The listed phone number is (612) 543-2500.
What is Antonique Peterson's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Antonique Peterson enrolled in Medicare?
Yes. Antonique Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Antonique Peterson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Antonique Peterson reassigns Medicare benefits to Emory Physicians Group, LLC (Atlanta, GA). 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 Antonique Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Antonique Peterson accept?
Health plans from Oscar Health list Antonique 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 Antonique Peterson was last updated on October 27, 2021. 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.
# Mrs. Antonique Peterson, DO · NPI 1700377124
General Practice physician in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since May 21, 2018.
## Identity
- **NPI:** 1700377124 (Entity type: Individual)
- **Enumerated:** May 21, 2018
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 69440 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 1313 PENN AVE N, Minneapolis, MN 55411-3047
- **Phone:** (612) 543-2500
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Emory Physicians Group, LLC (NPI 1548680796, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Arizona College Of Osteopathic Medicine Mid Western University, class of 2018
## Record status
- **NPPES last updated:** October 27, 2021
- **Other identifiers:** Medicaid 416005801 (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1700377124) · Data from the CMS NPPES public registry.