Mr Russell Henry Peterson, MS in Idaho Falls, ID

Mr Russell Henry Peterson, MS is a medicare enrolled "Counselor - Mental Health" provider in Idaho Falls, Idaho. His current practice location is 2375 E Sunnyside Rd, Suite C, Idaho Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 529-5777.

Mr Russell Henry Peterson is licensed to practice in Idaho (license number LCPC-3125) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093879637.

Contact Information

	Mr Russell Henry Peterson, MS
	2375 E Sunnyside Rd, Suite C, Idaho Falls, ID 83404-8280
	(208) 529-5777
	(208) 529-5778

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Russell Henry Peterson
Gender	Male
Speciality	Counselor - Mental Health
Location	2375 E Sunnyside Rd, Idaho Falls, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093879637
Provider Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 6204270978
Enrollment ID: I20240221001874

Medical Identifiers

Medical identifiers for Mr Russell Henry Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093879637	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	LCPC-3125 (Idaho)	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. Mr Russell Henry Peterson allows following entities to bill medicare on his behalf.

Entity Name	John D Perovich Psyd Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265846976 PECOS PAC ID: 1850669094 Enrollment ID: O20170613000595

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. Mr Russell Henry 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
Mr Russell Henry Peterson, MS 4360 E 278 N, Rigby, ID 83442-5892 Ph: (208) 359-4775	Mr Russell Henry Peterson, MS 2375 E Sunnyside Rd, Suite C, Idaho Falls, ID 83404-8280 Ph: (208) 529-5777

Reviews and Comments

Counselor in Idaho Falls, ID

Desiree Jenks-asay, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 615 Hoopes Ave, Idaho Falls, ID 83401 Phone: 208-542-0352
Kelsey Lynn Cole, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 211 S Woodruff Ave Ste A3, Idaho Falls, ID 83401 Phone: 208-524-4818 Fax: 208-522-6630
Steven Orme, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 545 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-351-1447
Mckenzie Leigh Duncan, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1262 E 17th St, Idaho Falls, ID 83404 Phone: 208-346-0688 Fax: 208-620-3027
Mr. Jorge Padron, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 543 3rd St, Idaho Falls, ID 83401 Phone: 208-522-6925 Fax: 208-522-6934
Zachary Wixom, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 150 Shoup Ave, Idaho Falls, ID 83402 Phone: 208-528-5712
Jennie R Nelson, Counselor Medicare: Medicare Enrolled Practice Location: 115 E 16th St, Idaho Falls, ID 83404 Phone: 208-523-6727

Mr Russell Henry Peterson, MS - Medicare Counselor in Idaho Falls, ID