MADELINE RENEE PETERS MD
NPI 1912580622
Pediatrics in Shakopee, MN
About Madeline Renee Peters Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MADELINE RENEE PETERS MD (NPI 1912580622) is an individual pediatrics provider in Shakopee, Minnesota, licensed in Minnesota (76919) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Minneapolis.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Madeline Renee Peters Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Madeline Peters reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
St Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Park Nicollet Clinic
- 2,527 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55379 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Madeline Peters's NPI number?
The NPI number for Madeline Peters is 1912580622. It was assigned to this individual provider in the NPPES registry on April 30, 2021.
Where is Madeline Peters located?
Madeline Peters practices at 1415 Saint Francis Ave, Shakopee, MN 55379. The listed phone number is (952) 993-7750.
What is Madeline Peters's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Madeline Peters enrolled in Medicare?
Yes. Madeline Peters is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Madeline Peters's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Madeline Peters reassigns Medicare benefits to Park Nicollet Methodist Hospital (St Louis Park, 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 Madeline Peters's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Madeline Peters was last updated on July 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Madeline Renee Peters, MD · NPI 1912580622
Pediatrics physician in Shakopee, Minnesota. Individual provider, active in the CMS NPPES registry since April 30, 2021.
## Identity
- **NPI:** 1912580622 (Entity type: Individual)
- **Enumerated:** April 30, 2021
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 76919 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1415 SAINT FRANCIS AVE, Shakopee, MN 55379-3374
- **Phone:** (952) 993-7750
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Park Nicollet Methodist Hospital (NPI 1194113217, St Louis Park, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1912580622) · Data from the CMS NPPES public registry.