Dr Nicolas Lee Peters, MD in Gallup, NM

Dr Nicolas Lee Peters, MD is a medicare enrolled "Pediatrics" physician in Gallup, New Mexico. His current practice location is 2111 College Dr, Gallup, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 863-1820.

Dr Nicolas Lee Peters is licensed to practice in New Mexico (license number MD2017-0087) 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 1487844791.

Contact Information

	Dr Nicolas Lee Peters, MD
	2111 College Dr, Gallup, NM 87301-5600
	(505) 863-1820
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Nicolas Lee Peters
Gender	Male
Speciality	Pediatrics
Location	2111 College Dr, Gallup, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487844791
Provider Enumeration Date: 08/01/2007
Last Update Date: 02/05/2020

Medicare PECOS Information:

PECOS PAC ID: 6608023130
Enrollment ID: I20120905000699

Medical Identifiers

Medical identifiers for Dr Nicolas Lee Peters such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487844791	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	35.094612 (Ohio)	Secondary
208000000X	Pediatrics	48190 (Arizona)	Secondary
2080P0207X	Pediatrics - Pediatric Hematology-oncology	35.094612 (Ohio)	Secondary
2080P0207X	Pediatrics - Pediatric Hematology-oncology	48190 (Arizona)	Secondary
208M00000X	Hospitalist	MD2017-0087 (New Mexico)	Secondary
208M00000X	Hospitalist	48190 (Arizona)	Secondary
246QM0706X	Specialist/technologist, Pathology - Medical Technologist	(* (Not Available))	Secondary
208000000X	Pediatrics	MD2017-0087 (New Mexico)	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 Nicolas Lee Peters allows following entities to bill medicare on his behalf.

Entity Name	Pediatric Academic Association, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063419943 PECOS PAC ID: 2961306774 Enrollment ID: O20031124000198

Entity Name	Muskingum Valley Health Centers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205018348 PECOS PAC ID: 4789760216 Enrollment ID: O20080618000216

Entity Name	Pediatrix Medical Group Of Ohio Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467559179 PECOS PAC ID: 2365672730 Enrollment ID: O20140304000984

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 Nicolas Lee Peters 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
Dr Nicolas Lee Peters, MD 70 S Val Vista Dr Ste A3-618, Gilbert, AZ 85296-0942 Ph: (480) 485-5166	Dr Nicolas Lee Peters, MD 2111 College Dr, Gallup, NM 87301-5600 Ph: (505) 863-1820

Reviews and Comments

Pediatrics Doctors in Gallup, NM

Dr. Carlos Manuel De Sanctis, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Ramona V. Anderson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 East Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Dr. John Edward Ratmeyer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Michelle Stam-maclaren, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2111 College Drive, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301 Phone: 505-863-1820
Janet M Li-tempest, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Gary A Escudero, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd, Box 1337, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1397
Dr. Gayle Ann Harrison, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2111 College Dr, Gallup, NM 87301 Phone: 505-863-1820 Fax: 505-863-1898

Dr Nicolas Lee Peters, MD - Medicare Pediatrics in Gallup, NM