DR. SPENCER O'BRIEN PETERSON D.O.
NPI 1962851667
Pediatrics in Tucson, AZ

Q: What is Spencer Peterson's NPI number?

The NPI number for Spencer Peterson is 1962851667. It was assigned to this individual provider in the NPPES registry on June 3, 2016.

Q: What is Spencer Peterson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Peterson was last updated on August 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 03, 2016PECOS Enrolled

4175 S. ALAMO AVE, TUCSON, AZ 85707(520) 228-2700 Get Directions Write a Review

NPPES record last updated: August 10, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 10, 2020, Apr 20, 2017 (2 updates tracked since 2017).

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About Dr. Spencer O'brien Peterson D.o. NPPES

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

DR. SPENCER O'BRIEN PETERSON D.O. (NPI 1962851667) is an individual pediatrics provider in Tucson, Arizona, licensed in Utah (11236456-1204) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962851667

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. SPENCER O'BRIEN PETERSONCredential: D.O.

Location Address4175 S. ALAMO AVETucson, AZ 85707-4405

Mailing Address4175 S. Alamo AveTucson, AZ 85707-4405 · (520) 228-2700

Phone(520) 228-2700

Sole ProprietorNo

Enumeration DateJune 3, 2016

Last NPPES UpdateAugust 10, 20202 updates tracked since enumeration

NPPES CertifiedAugust 10, 2020

✔ NPI 1962851667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in UT · 11236456-1204

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License R-07-2016MNT (NM)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4175 S. ALAMO AVE, Tucson, AZ 85707

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Spencer O'brien Peterson D.o. 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.

Medicare Billing Reassignment

Medicare enrollment records show Spencer Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Banner Physician Super Specialists Arizona LLC

83 mi

Multi-Specialty

37100 N GANTZEL RD STE 214
San Tan Valley, AZ 85140

Reassigned Medicare billing, Arizona enrollment
188 clinicians in this Medicare group

NPI 1396014403 (480) 412-9400

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 85707 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

Other Providers at the Same Location NPPES 15

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

DR. BRETT MYUNGSOO CHUNG DDS

Dentist (General Practice)

4175 S. ALAMO AVE
DAVIS-MONTHAN AFB, AZ 85707

Pima County (520) 228-2792

DEMETRIC JONES OD

Optometrist

4175 S. ALAMO AVE
DAVIS MONTHAN AFB, AZ 85707

Pima County (520) 228-2615

MICHAEL DAVID JENSEN

Nurse Practitioner (Family)

4175 S. ALAMO AVE
TUCSON, AZ 85707

Pima County (520) 228-2615

MICHAEL A PISCHKE

Physician Assistant

4175 S. ALAMO AVE, DAVIS-MONTHAN AFB
TUCSON, AZ 85707

Pima County (651) 485-2698

AGIN GHEEVARUGHESE THOMAS MD

Psychiatry & Neurology (Psychiatry)

4175 S. ALAMO AVE
TUCSON, AZ 85707

Pima County (520) 228-2615

ELIZABETH FLAHERTY

Dentist

4175 S. ALAMO AVE
TUCSON, AZ 85707

Pima County (520) 228-2650

KAELE R COOPER PT, DPT

Physical Therapist

4175 S. ALAMO AVE
TUCSON, AZ 85707

Pima County (520) 228-2778

DR. NICHOLAS MILLER DDS

Dentist (General Practice)

4175 S. ALAMO AVE
DAVIS MONTHAN AFB, AZ 85707

Pima County (937) 228-1506

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 Spencer Peterson's NPI number?

The NPI number for Spencer Peterson is 1962851667. It was assigned to this individual provider in the NPPES registry on June 3, 2016.

Where is Spencer Peterson located?

Spencer Peterson practices at 4175 S. Alamo Ave, Tucson, AZ 85707. The listed phone number is (520) 228-2700.

What is Spencer Peterson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Spencer Peterson enrolled in Medicare?

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

Which organization bills Medicare for Spencer Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Spencer Peterson reassigns Medicare benefits to Banner Physician Super Specialists Arizona LLC (San Tan Valley, AZ). 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 Spencer Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Spencer Peterson accept?

Health plans from Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Spencer 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 Spencer Peterson was last updated on August 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.