NICHOLAS PETERSON (NPI# 1205493335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205493335 |
| Entity Type | Individual |
| Full Name | NICHOLAS PETERSON |
| Credential | MD |
| Practice Address |
3401 N Broad St Philadelphia PA 19140-5103 |
| Practice Telephone | 2157072000 |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MT217438 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609313782 | Nicholas Peterson | Physical Therapy Assistant | 9550 Highway 412 W, Lexington, TN 38351-5849 | 2017-01-26 |
| 1619357696 | Nicholas L Peterson | Physical Therapist | 6420 County Road 335 Unit B, New Castle, CO 81647-9691 | 2015-06-04 |
| 1629456124 | Nicholas Scott Peterson | Pediatrics | 1200 Childrens Ave Ste 12200, Oklahoma City, OK 73104 | 2015-05-15 |
| 1639281363 | Nicholas James Peterson | Dentist | Psc 557 Box 2963, Fpo, AP 96379 | 2006-08-31 |
| 1912513102 | Nicholas Ronald Peterson | Counselor | 150 W 1st St Ste 270, New Richmond, WI 54017-1770 | 2020-09-22 |
| 1619505229 | Nicholas Vernon Peterson | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Surgery, Los Angeles, CA 90095-7419 | 2020-03-30 |
| 1386297869 | Nicholas Peterson | Anesthesiologist Assistant | 900 23rd St Nw, Washington, DC 20037-2342 | 2019-07-23 |
| 1689230450 | Nicholas Edward Peterson | Physical Medicine & Rehabilitation | 410 Church St Se, Minneapolis, MN 55455-0222 | 2019-05-16 |
| 1942505037 | Nicholas Peterson | Counselor | 669 S Haywood St, Waynesville, NC 28786-6703 | 2011-01-20 |
| 1346576923 | Nicholas J Peterson | Registered Nurse | 780 Albany St, Boston, MA 02118-2524 | 2009-11-02 |
| Street Address |
3401 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205133 | Shefali Agrawal | Specialist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2005-06-15 |
| 1962018523 | Caroline Grace Kelly | Audiologist | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-09-18 |
| 1457965964 | Barbara Ohiaeri | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-09-02 |
| 1710505904 | Cara Greenspan | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-14 | |
| 1013535756 | Srinivasa Prasad Venkata Kanuparthi | Neurological Surgery | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1417575143 | Sakshi Gandhi | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1801414594 | Azka Rahman | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-08 |
| 1417574658 | Anna-kaye Marie Brown | Anesthesiology | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-04 |
| 1285251405 | Shalonda Cook | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| 1386261501 | Temidayo Aderibigbe | Orthopaedic Surgery | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1962993170 | Brian M Till | Surgery | 1015 Walnut Street, Suite 620 Curtis, Philadelphia, PA 19107-5005 | 2018-05-23 |
| 1356838932 | Walker Lyons | Surgery | 1015 Walnut St Ste 210, Philadelphia, PA 19107-5005 | 2018-04-18 |
| 1790213114 | Matthew Paul Mullarkey | Surgery | 3401 N Broad St Ste C405, Philadelphia, PA 19140-5103 | 2017-05-30 |
| 1528424090 | Zhen Lu | Surgery | 5401 Old York Rd # Klein101, Philadelphia, PA 19141-3030 | 2016-01-13 |
| 1235517996 | David Kim | Surgery | 3401 N Broad St # 3ppc388, Philadelphia, PA 19140 | 2015-05-14 |
| 1578941282 | Amanda Elizabeth Deliere | Surgery | 3400 N Broad St, Philadelphia, PA 19140-5104 | 2015-05-13 |
| 1649660804 | Deviney Rattigan | Surgery | 1110 Lombard St Apt 24, Philadelphia, PA 19147-1206 | 2015-01-27 |
| 1346676988 | Aviva Wallace Kaplin | Surgery | 20 E Abington Ave, Philadelphia, PA 19118-3410 | 2013-09-15 |
| 1619300571 | Roshin Thomas | Surgery | 8815 Germantown Ave Fl 2, Philadelphia, PA 19118-2722 | 2013-08-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.