Shane Stean Peterson, DO - Medicare Diagnostic Radiology in Orlando, FL

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Shane Stean Peterson, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Orlando, Florida. He went to Arizona College Of Osteopathic Medicine Mid Western University and graduated in 2019 and has 7 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Mayo Clinic, Florida Radiology Imaging At Lake Mary Llc and his current practice location is 601 E Rollins St, Adventhealth Medical Group Radiology At Central Florida, Orlando, Florida. You can reach out to his office (for appointments etc.) via phone at (407) 200-2355.

Shane Stean Peterson is licensed to practice in Florida (license number OS22276) 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 1609439066.

Contact Information

Shane Stean Peterson, DO
601 E Rollins St, Adventhealth Medical Group Radiology At Central Florida,
Orlando, FL 32803-1248
(407) 200-2355
Not Available

Map and Direction




Physician's Profile

Full NameShane Stean Peterson
GenderMale
SpecialityDiagnostic Radiology
Experience7 Years
Location601 E Rollins St, Orlando, Florida
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Shane Stean Peterson attended and graduated from Arizona College Of Osteopathic Medicine Mid Western University in 2019
  NPI Data:
  • NPI Number: 1609439066
  • Provider Enumeration Date: 04/20/2019
  • Last Update Date: 09/08/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0345785721
  • Enrollment ID: I20240710000234

Medical Identifiers

Medical identifiers for Shane Stean Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609439066NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology OS22276 (Florida)Primary
2085R0202XRadiology - Diagnostic Radiology 069426 (Connecticut)Secondary
2085R0202XRadiology - Diagnostic Radiology 76770 (Minnesota)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Mayo Clinic Hospital RochesterRochester, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mayo Clinic65077782554507
Florida Radiology Imaging At Lake Mary Llc1254311137217

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. Shane Stean Peterson allows following entities to bill medicare on his behalf.
Entity NameMayo Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922074434
PECOS PAC ID: 6507778255
Enrollment ID: O20031103000285
Entity NameConnecticut Imaging Partners Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740315761
PECOS PAC ID: 4183649098
Enrollment ID: O20240911000281
Entity NameFarmington Imaging Center Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275987802
PECOS PAC ID: 7719265651
Enrollment ID: O20240911004039
Entity NameTic Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457702813
PECOS PAC ID: 4880972819
Enrollment ID: O20240920000661
Entity NameJefferson Radiology Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396795951
PECOS PAC ID: 8729982525
Enrollment ID: O20241010002687

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. Shane Stean 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 AddressPractice Location Address
Shane Stean Peterson, DO
Po Box 946414,
Atlanta, GA 30394-6414

Ph: (407) 200-2355		Shane Stean Peterson, DO
601 E Rollins St, Adventhealth Medical Group Radiology At Central Florida,
Orlando, FL 32803-1248

Ph: (407) 200-2355

Reviews and Comments


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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.

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