Dr Samuel Petersen, DMD - Medicare Dentist in Eagle, ID

Dr Samuel Petersen, DMD is a medicare enrolled "Dentist - General Practice" provider in Eagle, Idaho. His current practice location is 450 W State St Ste 115, Eagle, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 370-5203.

Dr Samuel Petersen is licensed to practice in Idaho (license number D-5038) 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 1720571284.

Contact Information

Dr Samuel Petersen, DMD
450 W State St Ste 115,
Eagle, ID 83616-7055
(208) 370-5203
(208) 370-5204

Map and Direction




Healthcare Provider's Profile

Full NameDr Samuel Petersen
GenderMale
SpecialityDentist - General Practice
Location450 W State St Ste 115, Eagle, Idaho
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1720571284
  • Provider Enumeration Date: 06/10/2018
  • Last Update Date: 02/28/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1052661279
  • Enrollment ID: I20180910002871

Medical Identifiers

Medical identifiers for Dr Samuel Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720571284NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist 10136 (Kentucky)Secondary
1223G0001XDentist - General Practice D-5038 (Idaho)Primary

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 Samuel 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 AddressPractice Location Address
Dr Samuel Petersen, DMD
450 W State St Ste 115,
Eagle, ID 83616-7055

Ph: (208) 370-5203
Dr Samuel Petersen, DMD
450 W State St Ste 115,
Eagle, ID 83616-7055

Ph: (208) 370-5203

Reviews and Comments


Dentist in Eagle, ID

Dr. Evan Hathaway, DDS
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Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616
Phone: 208-377-1161    Fax: 208-938-0567
Colton Charles, DMD
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Practice Location: 450 W State St Ste 180, Eagle, ID 83616
Phone: 208-939-0600    
Dr. Joel Edward Courtial, DDS
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Practice Location: 151 Stierman Way, Eagle, ID 83616
Phone: 208-939-4111    Fax: 208-939-3701
George D. Chen, DDS
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Practice Location: 1564 E Crowne Point Dr, Eagle, ID 83616
Phone: 916-508-2435    Fax: 916-983-6201
Dr. Michael G Dolby, DDS
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Practice Location: 90 Cottonwood Ct Ste 100, Eagle, ID 83616
Phone: 208-323-8545    Fax: 208-938-1401
Donald E Larson, D.M.D.
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Practice Location: 700 E State St Ste 100, Eagle, ID 83616
Phone: 208-939-3500    Fax: 208-939-9897
Dr. Ryan N Van Alfen, DDS, PLC
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Medicare: Not Enrolled in Medicare
Practice Location: 483 S Rivershore Ln Ste 102, Eagle, ID 83616
Phone: 208-938-2100    Fax: 208-938-0676

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.