DR. MATTHEW JAMES PETERSEN (NPI# 1972767556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972767556 |
Entity Type | Individual |
Full Name | DR. MATTHEW JAMES PETERSEN |
Credential | M.D. |
Practice Address |
1701 N Senate Blvd Radiology Dept Indianapolis IN 46202-1239 |
Mailing Address |
714 N Senate Ave Ste 100 Indianapolis IN 46202-3763 |
Practice Telephone | 3179625740 |
Enumeration Date | 2008-07-14 |
Last Update Date | 2011-10-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01069464A | IN | Allopathic & Osteopathic Physicians |
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
11013619A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 201027110 | 05 | |
IN | RAILROAD MEDICARE | P00966874 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477607083 | Matthew D. Petersen | Specialist/Technologist, Other | 11704 W Center Rd Ste 200, Omaha, NE 68144-4327 | 2007-01-22 |
1710062351 | Matthew Petersen | Urology | 24 Research Way, Suite 500, East Setauket, NY 11733 | 2006-10-25 |
1396206397 | Matthew Petersen | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd Ste 4102, Gainesville, FL 32610-3003 | 2019-03-31 |
1629565767 | Matthew Gary Petersen | Student in an Organized Health Care Education/Training Program | 2150 Pennsylvania Ave Nw, Washington, DC 20037-3201 | 2018-04-14 |
1053764639 | Matthew Petersen | Physician Assistant | 11800 Fm 1960 Rd W, Houston, TX 77065-3840 | 2016-07-19 |
1154554004 | Matthew Joel Petersen | Counselor | 711 Stanton L Young Blvd, Oklahoma City, OK 73104-5023 | 2009-08-26 |
1558569038 | Matthew L Petersen | Family Medicine | 4600 Valley Road, Suite 200, Lincoln, NE 68510-4844 | 2007-07-06 |
Street Address |
1701 N SENATE BLVD RADIOLOGY DEPT |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46202-1239 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073501235 | Lara Jane Pesavento | Anesthesiology | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2005-10-12 |
1508475526 | Wade Everett Oliver | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-27 |
1538778600 | Marleana Leann Groh | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-07-24 |
1982225447 | Saily Jacqueline Guerra | Dietitian, Registered | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-05-06 |
1013538826 | Paige Randolph | Nurse Practitioner | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-05-04 |
1780213926 | John Peacock | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-08 |
1295354462 | Kylie J Miller | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-08 |
1962031492 | Kristina Lynn Mathey | Counselor | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-06 |
1023647674 | Lindsay Nicole Troyer | Student in an Organized Health Care Education/Training Program | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-04-06 |
1548894686 | Courtney Leanne Kroes | Social Worker | 1701 N Senate Blvd, Indianapolis, IN 46202-1239 | 2020-02-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790386886 | Sara Brooke Horn | Registered Nurse | 1801 N Senate Ave Ste 3300, Indianapolis, IN 46202 | 2020-11-04 |
1013521905 | Zachary Camden Grimes | Registered Nurse | 720 Eskenazi Avenute, Indianapolis, IN 46202 | 2020-09-08 |
1790314045 | Scott C Mitchell II | Student in an Organized Health Care Education/Training Program | Indiana University School of Medicine Dept of Neurosurg, 355 W. 16th St, Gh 5100, Indianapolis, IN 46202 | 2020-04-07 |
1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
1124657697 | Betsy Wilson Stevens | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Drive, Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
1093340580 | Brian T Edmonds | Social Worker | Sandra Eskenazi Mental Health Center, 1700 N Illinois St, Indianapolis, IN 46202 | 2020-03-05 |
1326683210 | Lindsay Nicole Rich | Nurse Practitioner | 1800 N Senate Ave, Indianapolis, IN 46202 | 2019-11-14 |
1427693670 | Ronald Mcdonald House Charities of Central Indiana | Voluntary or Charitable | 435 Limestone Street, Indianaplois, IN 46202 | 2019-11-12 |
1790344760 | Kirsten Denise Leaberry | Student in an Organized Health Care Education/Training Program | Iu Health Neuroscience Center, Goodman Hall, 355 West 16th Street, Indianapolis, IN 46202 | 2019-06-12 |
1679138093 | Chris Olson Jr. | Student in an Organized Health Care Education/Training Program | 1701 N. Senate Blvd, Ag012, Indianapolis, IN 46202 | 2019-05-02 |
Find all providers in zip 46202 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598235566 | A Mri, LLC | Radiology | 7301 N Shadeland Ave Ste 1d, Indianapolis, IN 46250-2085 | 2018-12-03 |
1992138804 | George Byington Pratt IIi | Radiology | 9015 Crystal Lake Drive, Indianapolis, IN 46240 | 2013-08-14 |
1922340439 | Ted Alexander Seltman | Radiology | 550 University Blvd Rm 663, Indianapolis, IN 46202-5149 | 2013-03-22 |
1386919488 | Paul Joseph Niziolek | Radiology | 714 N Senate Ave Ste 100, Indianapolis, IN 46202 | 2012-03-21 |
1770862328 | Oscar Danilo Rosales | Radiology | 1001 W 10st, Wishard Hospital West Building M200, Indianapolis, IN 46202 | 2011-08-15 |
1326362120 | Jaimie M. Howell | Radiology | 714 N Senate Blvd., Suite 100, Indianapolis, IN 46202-3297 | 2010-03-23 |
1558525535 | Joel A Yalowitz | Radiology | 3907 Guilford Ave, Indianapolis, IN 46205-2827 | 2008-07-18 |
1891958757 | George Louis Trilikis | Radiology | 550 N University Blvd Room 0641, Dept of Radiology In University School of Medicine, Indianapolis, IN 46202 | 2008-07-09 |
1366604134 | Ian Wong | Radiology | 924 Fayette St, Indianapolis, IN 46202-3019 | 2008-07-01 |
1780845941 | Megan Beth Marine | Radiology | 550 University Blvd Rm 641, Indianapolis, IN 46202-5149 | 2008-06-20 |
Find all providers in INDIANAPOLIS |
City | INDIANAPOLIS |
Zip Code | 46202 |
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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.