Mark Peterson, is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Scott Depot, West Virginia. His current practice location is
111 Great Teays Blvd Ste 101, Scott Depot, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 757-8803.
Mark Peterson is licensed to practice in West Virginia (license number 30925) 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 1477043842.
Physician's Profile
| Full Name | Mark Peterson |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 111 Great Teays Blvd Ste 101, Scott Depot, West Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1477043842
- Provider Enumeration Date: 05/11/2018
- Last Update Date: 05/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 1557740883
- Enrollment ID: I20220616002270
Medical Identifiers
Medical identifiers for Mark Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477043842 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 30925 (West Virginia) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 30925 (West Virginia) | Secondary |
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. Mark Peterson allows following entities to bill medicare on his behalf.
| Entity Name | Valley Health Systems, Inc |
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| Entity Type | Part B Supplier - Public Health/welfare Agency |
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| Entity Identifiers | NPI Number: 1902962368
PECOS PAC ID: 9931017969
Enrollment ID: O20040325000411 |
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| Entity Name | Hhc River Park Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477622603
PECOS PAC ID: 2365478252
Enrollment ID: O20051206000168 |
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| Entity Name | Valley Health Systems, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720333461
PECOS PAC ID: 9931017969
Enrollment ID: O20130319000031 |
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| Entity Name | Valley Health Systems, Inc |
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| Entity Type | Part B Supplier - Public Health/welfare Agency |
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| Entity Identifiers | NPI Number: 1548542277
PECOS PAC ID: 9931017969
Enrollment ID: O20130415000484 |
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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. Mark 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 |
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Mark Peterson,
Po Box 1680,
Huntington, WV 25717-1680
Ph: (304) 781-5159 | Mark Peterson,
111 Great Teays Blvd Ste 101,
Scott Depot, WV 25560-9548
Ph: (304) 757-8803 |
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