DR. CHARLES EDWIN PETERSON (NPI# 1558472613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558472613 |
| Entity Type | Individual |
| Full Name | DR. CHARLES EDWIN PETERSON |
| Credential | MD |
| Practice Address |
904 Meadow Lane Schenectady NY 12309 |
| Practice Telephone | 5183934427 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 83493 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MVP | 11123 | 01 | |
| NY | 00641667 | 05 | |
| CDPHP | 10001599 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609026897 | Charles Marquis Peterson | Internal Medicine | 12910 Dalyn Dr, Potomac, MD 20854-1176 | 2008-09-24 |
| 1134243355 | Charles Mark Peterson | Registered Nurse | 830 14th Ave, Seattle, WA 98122-4508 | 2007-03-16 |
| 1902973415 | Charles Walter Peterson | Optometrist | 904 Elliott Ave N, Wenatchee, WA 98801-1666 | 2006-11-29 |
| 1700845526 | Charles A Peterson | Orthopaedic Surgery | 8438 N Mercer Way, Mercer Island, WA 98040-3134 | 2006-03-21 |
| 1952302143 | Charles Smith Peterson | Family Medicine | 3130 E Baseline Rd, Suite 101, Mesa, AZ 85204-7290 | 2005-08-10 |
| 1871036798 | Charles Capdeville Peterson | Family Medicine | 801 S Chevy Chase Dr Ste 230, Glendale, CA 91205-4436 | 2016-11-25 |
| 1154798502 | Charles Peterson | Counselor | 185 Silas Deane Hwy, Wethersfield, CT 06109 | 2015-09-01 |
| 1982018818 | Charles William Peterson Iv | Behavioral Analyst | 21929 Highland Knolls Dr, Katy, TX 77450-5873 | 2014-06-18 |
| 1295026821 | Charles John Peterson | Student in an Organized Health Care Education/Training Program | 308 Harvard St Se, Minneapolis, MN 55455-0343 | 2011-05-01 |
| 1437234499 | Charles John Peterson | Emergency Medicine | 5301 E Grant Road, Tucson Medical Center Emergency Department, Tucson, AZ 85712-2805 | 2006-10-26 |
| Street Address |
904 MEADOW LANE |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973071 | Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center | Clinic/Center | 1769 Union Street, 3rd Floor, Niskayana, NY 12309 | 2019-07-11 |
| 1902396351 | Erica S Hill | Occupational Therapist | 2246 Van Rensselaer Dr, Niskayuna, NY 12309 | 2018-05-11 |
| 1588107015 | Orthopedicsny, LLP | Orthopaedic Surgery | 1760 Union St, Suite 100, Schenectady, NY 12309 | 2016-12-01 |
| 1932589983 | Patricia P Primomo | Dentist | 2310 Nott Street East, Niskayuna, NY 12309 | 2015-06-04 |
| 1386074268 | Bernard P Kinlan | Social Worker | 1 Ascot Lane, Terrace At Glen Eddy, Niskayuna, NY 12309 | 2013-11-14 |
| 1255680344 | Rudy Nydegger Phd, Abpp, Pllc | Psychologist | 2317 Balltown Rd., Suite 203, Schenectady, NY 12309 | 2012-09-05 |
| 1407104094 | Rachelle Ann Kehoe | Specialist | 950 St. David's Lane, Schenectady, NY 12309 | 2012-08-29 |
| 1073882726 | Kristina Lynn Deangelo | Speech-Language Pathologist | 1872 Hexam Road West, Niskayuna, NY 12309 | 2011-12-27 |
| 1467720136 | Jjm Chiropractic, LLC | Chiropractor | 1756 Union St., Niskayuna, NY 12309 | 2011-12-08 |
| 1659658474 | Richard W Glover | Dentist | 2310 Nott St. East, Niskayuna, NY 12309 | 2011-11-08 |
| Find all providers in zip 12309 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821417221 | Caitlin Sonagere | Internal Medicine | 1201 Nott St Ste 102, Schenectady, NY 12308-2589 | 2014-04-14 |
| 1104109065 | Community Care Physicians, PC | Internal Medicine | 2546 Balltown Road, Suite 200, Schenectady, NY 12309-1079 | 2011-09-27 |
| 1487821781 | Homedical Associates | Internal Medicine | 1737 Union St, Pmb 741m, Schenectady, NY 12309-6242 | 2008-05-15 |
| 1033388905 | Dominic Raymond Cirincione | Internal Medicine | 915 Londonderry Ct, Schenectady, NY 12309 | 2008-02-26 |
| 1770526972 | Christine Napolitano | Internal Medicine | 124 Rosa Rd, Suite 382, Schenectady, NY 12308 | 2006-06-14 |
| 1164473526 | Venkateswararao Voleti | Internal Medicine | 700 Mcclellan St Ste 103, Schenectady, NY 12304-1019 | 2006-05-12 |
| 1053378539 | Anita K Burock Stotts | Internal Medicine | 100 Anthony Way, Schenectady, NY 12303-3512 | 2006-04-27 |
| 1477535458 | Ali Y Mirza | Internal Medicine | 1150 Nott St, Nott Street Medical Pllc, Schenectady, NY 12308-2426 | 2005-11-16 |
| 1881686988 | Margaret R Carley | Internal Medicine | 76 Birchwood Ln, Schenectady, NY 12309-1835 | 2005-08-16 |
| 1548262991 | Nasrene R Yadegari-lewis | Internal Medicine | 3757 Carman Rd, Suite 100, Schenectady, NY 12303 | 2005-08-15 |
| Find all providers in SCHENECTADY | ||||
| City | SCHENECTADY |
| Zip Code | 12309 |
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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.