Brian Walter Petersen, DO is a medicare enrolled "Orthopaedic Surgery" physician in Shelbyville, Tennessee. He went to At Still University Of Health Sciences, College Of Osteo Med, Kirksville and graduated in 2004 and has 20 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Advanced Diagnostic Imaging Pc and his current practice location is
120 Frank Martin Rd Ste 200, Shelbyville, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 488-8700.
Brian Walter Petersen is licensed to practice in Tennessee (license number 2291) 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 1861693095.
Physician's Profile
| Full Name | Brian Walter Petersen |
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| Gender | Male |
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| Speciality | Orthopedic Surgery |
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| Experience | 20 Years |
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| Location | 120 Frank Martin Rd Ste 200, Shelbyville, Tennessee |
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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:
- Brian Walter Petersen attended and graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2004
NPI Data:
- NPI Number: 1861693095
- Provider Enumeration Date: 05/28/2007
- Last Update Date: 02/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 3375697386
- Enrollment ID: I20110906000149
Medical Identifiers
Medical identifiers for Brian Walter Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1861693095 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207X00000X | Orthopaedic Surgery | TL1160 (Wyoming) | Secondary |
| 207X00000X | Orthopaedic Surgery | 2291 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Advanced Diagnostic Imaging Pc | 7315848140 | 545 |
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. Brian Walter Petersen allows following entities to bill medicare on his behalf.
| Entity Name | Saint Thomas Medical Partners |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437194669
PECOS PAC ID: 1557269354
Enrollment ID: O20031230000470 |
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| Entity Name | Advanced Diagnostic Imaging Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093741464
PECOS PAC ID: 7315848140
Enrollment ID: O20040115000677 |
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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. Brian Walter 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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Brian Walter Petersen, DO
3024 Business Park Cir,
Goodlettsville, TN 37072-3132
Ph: (615) 239-2018 | Brian Walter Petersen, DO
120 Frank Martin Rd Ste 200,
Shelbyville, TN 37160-7195
Ph: (931) 488-8700 |
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