MISS ALICE RUTH PETERSON P.A.-C.
NPI 1871654418
Physician Assistant - Medical in Phoenix, AZ

Q: What is Alice Peterson's NPI number?

The NPI number for Alice Peterson is 1871654418. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Q: What is Alice Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Alice Peterson was last updated on December 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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 December 13, 2006PECOS EnrolledAccepts Medicare Assignment

4545 E CHANDLER BLVD STE 104, PHOENIX, AZ 85048(480) 728-4400(480) 728-4411 Get Directions Write a Review

NPPES record last updated: December 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 11, 2024, Mar 7, 2023, Jul 16, 2019 (3 updates tracked since 2019).

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About Miss Alice Ruth Peterson P.a.-c. NPPES

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

MISS ALICE RUTH PETERSON P.A.-C. (NPI 1871654418) is an individual medical provider in Phoenix, Arizona, licensed in Arizona (2837) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Chandler, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2003).

NPPES Registry Identity

NPI1871654418

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMISS ALICE RUTH PETERSONCredential: P.A.-C.

Location Address4545 E CHANDLER BLVD STE 104Phoenix, AZ 85048-7647

Mailing AddressPo Box 33269Phoenix, AZ 85067-3269 · (602) 406-4786 · Fax (916) 636-4358

Phone(480) 728-4400

Fax(480) 728-4411

Sole ProprietorNo

Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2003

Enumeration DateDecember 13, 2006

Last NPPES UpdateDecember 11, 20243 updates tracked since enumeration

NPPES CertifiedDecember 11, 2024

✔ NPI 1871654418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in AZ · 2837

Also ListedPhysician AssistantTaxonomy 363A00000X · License 2837 (AZ)

4545 E CHANDLER BLVD STE 104, Phoenix, AZ 85048

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Secondary Practice Location 1

Location 1655 S Dobson Rd Ste B113Chandler, AZ 85224-5667 · Phone (480) 728-5020 · Fax (480) 899-5023

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Miss Alice Ruth Peterson P.a.-c. 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.

PECOS PAC ID6507041258

PECOS Enrollment IDI20110425000276

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.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

143 services99 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

129 services129 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

116 services91 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

17 services17 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

17 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers14 claims39 services$5.91 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 6

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

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