Charles E Peterson (NPI# 1326025495, PAC ID# 0244236073) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1326025495 |
| PAC ID by PECOS | 0244236073 |
| Professional Enrollment ID | I20091222000283 |
| Full Name | Charles E Peterson |
| Organization Legal Name | BEACON MEDICAL GROUP INC |
| Address |
621 Memorial Dr Suite 502 South Bend IN 46601-1075 |
| Phone Number | 5746475875 |
| Gender | M |
| Graduation Year | 1973 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 1254243306 |
| Number of Group Practice Members | 331 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150058 | MEMORIAL HOSPITAL OF SOUTH BEND |
| Address | Phone | Organization |
|---|---|---|
| 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 | 5742512100 | ALLIED PHYSICIANS OF MICHIANA, LLC |
| 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 | 5746475875 | BEACON MEDICAL GROUP INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_023_overall | Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) | 100% | |
| MIPS_EC_113_overall | Colorectal Cancer Screening | 66% | |
| MIPS_EC_128_overall | Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 92% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 88% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 98% |
| Organization Legal Name | BEACON MEDICAL GROUP INC |
| Physicians | 364 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nizar Fayez Olabi | Obstetrics/gynecology | Beacon Medical Group Inc | 1215 Lawn Ave, Suite 100, Elkhart, IN 46514-2450 |
| Mayank K Mittal | Interventional Cardiology | Beacon Medical Group Inc | 610 N Michigan St, 400 Bmg Adv Cardiology Specialists, South Bend, IN 46601-1081 |
| John A Whitney | Family Medicine | Beacon Medical Group Inc | 2235 Cleveland Rd, South Bend, IN 46628-3529 |
| Nicholas H Kerr | Hospice/palliative Care | Beacon Medical Group Inc | 1753 Fulton St, Elkhart, IN 46514-1927 |
| Amanda L Springer | Family Medicine | Beacon Medical Group Inc | 1815 E Ireland Rd, Beacon Medical Group Ireland Rd, South Bend, IN 46614-2845 |
| Oluyinka G Osunnuga | Nurse Practitioner | Beacon Medical Group Inc | 5314 Lincolnway E, Bmg Specialties Mishawaka, Mishawaka, IN 46544-4249 |
| Lana L Evans | Nurse Practitioner | Beacon Medical Group Inc | 207 N Elkhart St, Beacon Medical Group Wakarusa, Wakarusa, IN 46573-9729 |
| Lindsey Danielle Lira | Family Medicine | Beacon Medical Group Inc | 27082 Main St, Edwardsburg, MI 49112-9334 |
| Mercedes D Moran | Certified Nurse Midwife | Beacon Medical Group Inc | 813 S Michigan St, Memorial Neighborhood Health Center, South Bend, IN 46601-3102 |
| Beth A Hayden | Nurse Practitioner | Beacon Medical Group Inc | 900 I St, La Porte, IN 46350-5533 |
| Street Address |
621 MEMORIAL DR SUITE 502 |
| City | SOUTH BEND |
| State | IN |
| Zip | 46601-1075 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J Hall | Diagnostic Radiology | Beacon Medical Group Inc | 621 Memorial Dr, Suite 312, South Bend, IN 46601-1073 |
| Amanda Ann Aldana | Nurse Practitioner | Beacon Medical Group Inc | 621 Memorial Dr, Suite 312, South Bend, IN 46601-1073 |
| Gregory George Bingaman | Nurse Practitioner | Beacon Medical Group Inc | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 |
| Kevin Francis Cumper | Infectious Disease | Beacon Medical Group Inc | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 |
| Katherine D Goze | General Surgery | Beacon Medical Group Inc | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 |
| Daniela M Edson | Nurse Practitioner | Beacon Medical Group Inc | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 |
| Claire M Walker | Certified Nurse Midwife (cnm) | Beacon Medical Group Inc | 621 Memorial Dr, Suite 403, South Bend, IN 46601-1074 |
| Melissa E. Holderread | Certified Nurse Midwife (cnm) | Beacon Medical Group Inc | 621 Memorial Dr, Suite 403, South Bend, IN 46601-1074 |
| Mark A Thompson | General Surgery | Beacon Medical Group Inc | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 |
| Lourine Garcia Strozynski | Nurse Practitioner | Beacon Medical Group Inc | 621 Memorial Dr, Suite 502, South Bend, IN 46601-1075 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly W Mcguire | Obstetrics/gynecology | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Patrick J Brand | Qualified Audiologist | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Sara Baumgartner | Obstetrics/gynecology | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Edward P Delle Donne | Colorectal Surgery (proctology) | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Zhiquan Zhao | Obstetrics/gynecology | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Shannon Luczak | Nurse Practitioner | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Cheryl Ann Stahl | Nurse Practitioner | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Daniel F Czarnecki | Obstetrics/gynecology | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Michael C Rotkis | General Surgery | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Luis Alfonso Benavente Chenhalls | General Surgery | Allied Physicians of Michiana, LLC | 515 N Lafayette Blvd, Michiana Obstetrics and Gynecology, South Bend, IN 46601-1003 |
| Find all physicians in zip 46601 | |||
| City | SOUTH BEND |
| Zip Code | 46601 |
| Specialty | GENERAL SURGERY |
| City + Specialty | SOUTH BEND + GENERAL SURGERY |
Please comment or provide details below to improve the information on Charles E Peterson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.