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MR. ETHAN JAMES DEAN PETERSON M.D.
NPI 1891371480
Internal Medicine in Tampa, FL

Active since March 23, 2021PECOS Enrolled
13000 BRUCE B DOWN'S BLVD, TAMPA, FL 33612(813) 972-2000(813) 916-2944 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 10, 2024, Mar 23, 2021 (2 updates tracked since 2021).

About Mr. Ethan James Dean Peterson M.d. NPPES

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

MR. ETHAN JAMES DEAN PETERSON M.D. (NPI 1891371480) is an individual internal medicine provider in Tampa, Florida, licensed in Florida (ME165685) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891371480
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMR. ETHAN JAMES DEAN PETERSONCredential: M.D.
Location Address13000 BRUCE B DOWN'S BLVDTampa, FL 33612
Mailing Address13000 Bruce B Down's BlvdTampa, FL 33612 · (813) 681-5551 · Fax (813) 916-2944
Phone(813) 972-2000
Fax(813) 916-2944
Sole ProprietorYes
Enumeration DateMarch 23, 2021
Last NPPES UpdateSeptember 10, 20242 updates tracked since enumeration
NPPES CertifiedMarch 23, 2021
✔ NPI 1891371480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME165685
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
13000 BRUCE B DOWN'S BLVD, Tampa, FL 33612
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Ethan James Dean 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33612 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

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 Ethan Peterson's NPI number?

The NPI number for Ethan Peterson is 1891371480. It was assigned to this individual provider in the NPPES registry on March 23, 2021.

Where is Ethan Peterson located?

Ethan Peterson practices at 13000 Bruce B Down's Blvd, Tampa, FL 33612. The listed phone number is (813) 972-2000.

What is Ethan Peterson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ethan Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Ethan Peterson was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.