Dr Anicia Gwen Peterson, DC is a medicare enrolled "Chiropractor" provider in Crosslake, Minnesota. She went to Northwestern College Of Chiropractic and graduated in 1993 and has 31 years of diverse experience with area of expertise as Chiropractic. Her current practice location is
13743 E Shore Rd, Crosslake, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 692-1616.
Dr Anicia Gwen Peterson is licensed to practice in Minnesota (license number 3138) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003973702.
Healthcare Provider's Profile
| Full Name | Dr Anicia Gwen Peterson |
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| Gender | Female |
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| Speciality | Chiropractic |
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| Experience | 31 Years |
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| Location | 13743 E Shore Rd, Crosslake, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Anicia Gwen Peterson attended and graduated from Northwestern College Of Chiropractic in 1993
NPI Data:
- NPI Number: 1003973702
- Provider Enumeration Date: 01/02/2007
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 8325149560
- Enrollment ID: I20070718000589
Medical Identifiers
Medical identifiers for Dr Anicia Gwen Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003973702 | NPI | - | NPPES |
| 68D24NO | Other | MN | BCBS OFFICE ID # |
| 68D25PE | Other | MN | BCBS INDIVIDUAL ID # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 3138 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Anicia Gwen Peterson allows following entities to bill medicare on her behalf.
| Provider Name | Northwoods Chiropractic P A |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1477610194
PECOS PAC ID: 1951402197
Enrollment ID: O20070718000595 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Anicia Gwen Peterson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Anicia Gwen Peterson, DC
13743 E Shore Rd,
Crosslake, MN 56442-4033
Ph: (218) 692-1616 | Dr Anicia Gwen Peterson, DC
13743 E Shore Rd,
Crosslake, MN 56442-4033
Ph: (218) 692-1616 |
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