1. Home
  2. Directory
  3. Missouri
  4. Saint Louis
  5. Pediatrics
  6. NPI Profile

ROBERT LYNN PETERSEN MD
NPI 1912296757
Pediatrics - Pediatric Cardiology in Saint Louis, MO

Active since April 01, 2011PECOS EnrolledAccepts Medicare Assignment
1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 577-5380(314) 268-4141 Get Directions Write a Review

NPPES record last updated: October 3, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 18, 2021, Oct 7, 2019, Aug 14, 2018 (3 updates tracked since 2018).

About Robert Lynn Petersen Md NPPES

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

ROBERT LYNN PETERSEN MD (NPI 1912296757) is an individual pediatric cardiology provider in Saint Louis, Missouri, licensed in Missouri (2014011778) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (2011).

NPPES Registry Identity

NPI1912296757
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameROBERT LYNN PETERSENCredential: MD
Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003
Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003 · (314) 577-5380 · Fax (314) 268-4141
Phone(314) 577-5380
Fax(314) 268-4141
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 2011
Enumeration DateApril 1, 2011
Last NPPES UpdateOctober 3, 20253 updates tracked since enumeration
NPPES CertifiedOctober 3, 2025
✔ NPI 1912296757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in MO · 2014011778
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License 2014011778 (MO)
1465 S GRAND BLVD, Saint Louis, MO 63104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Robert Lynn Petersen Md 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 ID9739482878
PECOS Enrollment IDI20180724000453
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 Robert Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ssm Health Care Group
0.2 mi
Internal Medicine
1225 SOUTH GRAND BLVD, 2L - DOOR 3,4
Saint Louis, MO 63104
  • Reassigned Medicare billing, Missouri enrollment
  • 1,294 clinicians in this Medicare group
NPI 1306589544 (314) 977-6100

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.

DR. SARAH MARGARET HANLY PH.D.
Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5667
KAVIPRIYA KOMESWARAN
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000
ALEXIS HAAS STEWART
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-5700
NATALIE DRURY RD, LD
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5387
MS. MASHAL AZIZ RANA MBBS
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
ST.LOUIS, MO 63104
St. Louis City (314) 577-5382
TIMOTHY J KUTZ MD
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-6406
CHRISTOPHER SALLEE MD
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
St. Louis City (314) 577-1607
AMBER GRANA DO
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5695

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 Robert Petersen's NPI number?

The NPI number for Robert Petersen is 1912296757. It was assigned to this individual provider in the NPPES registry on April 1, 2011.

Where is Robert Petersen located?

Robert Petersen practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 577-5380.

What is Robert Petersen's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Robert Petersen enrolled in Medicare?

Yes. Robert Petersen 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 Robert Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Petersen reassigns Medicare benefits to Ssm Health Care Group (Saint Louis, MO). 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 Robert Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Petersen accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 4 other insurers list Robert Petersen 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 Robert Petersen was last updated on October 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.