David Petersen, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Greenwood Village, Colorado. He graduated from healthcare school in 2002 and has 23 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Sondermind Provider Network Llc, Sondermind Provider Network Llc and his current practice location is
6200 S Syracuse Way Ste 260, Greenwood Village, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 332-6767.
David Petersen is licensed to practice in Colorado (license number 255) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1497845788.
Healthcare Provider's Profile
| Full Name | David Petersen |
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| Gender | Male |
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| Speciality | Clinical Social Worker |
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| Experience | 23 Years |
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| Location | 6200 S Syracuse Way Ste 260, Greenwood Village, Colorado |
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| Accepts Medicare Assignments | Yes. He 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:
- David Petersen graduated from medical school in 2002
NPI Data:
- NPI Number: 1497845788
- Provider Enumeration Date: 10/15/2006
- Last Update Date: 01/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 2668441320
- Enrollment ID: I20040929000503
Medical Identifiers
Medical identifiers for David Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497845788 | NPI | - | NPPES |
| 099366 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 81 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | 255 (Colorado) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Sondermind Provider Network Llc | 9537572490 | 874 |
| Sondermind Provider Network Llc | 9537572490 | 874 |
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. David Petersen allows following entities to bill medicare on his behalf.
| Entity Name | Sondermind Provider Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760854442
PECOS PAC ID: 9537572490
Enrollment ID: O20210113002826 |
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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. David Petersen 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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David Petersen, LCSW
415 N Tejon St,
Colorado Springs, CO 80903-1101
Ph: (719) 332-6767 | David Petersen, LCSW
6200 S Syracuse Way Ste 260,
Greenwood Village, CO 80111-4739
Ph: (719) 332-6767 |
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