Amber Dawn Peterson, RN is a medicare enrolled "Nurse Practitioner - Family" in Harrisville, Utah. Her current practice location is
579 W 2425 N, Harrisville, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 648-6031.
Amber Dawn Peterson is licensed to practice in Utah (license number 8845405-4405) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1861187817.
Provider's Profile
Full Name | Amber Dawn Peterson |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 579 W 2425 N, Harrisville, Utah |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1861187817
- Provider Enumeration Date: 04/06/2023
- Last Update Date: 07/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 4587025986
- Enrollment ID: I20230801004746
Medical Identifiers
Medical identifiers for Amber Dawn Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1861187817 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 8845405-3102 (Utah) | Secondary |
363LF0000X | Nurse Practitioner - Family | 8845405-4405 (Utah) | 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. Amber Dawn Peterson allows following entities to bill medicare on her behalf.
Entity Name | Molina Healthcare Of Utah |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1619486396 PECOS PAC ID: 8224395041 Enrollment ID: O20171204002662 |
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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. Amber Dawn 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 |
Amber Dawn Peterson, RN 579 W 2425 N, Harrisville, UT 84414-7366 Ph: (801) 648-6031 | Amber Dawn Peterson, RN 579 W 2425 N, Harrisville, UT 84414-7366 Ph: (801) 648-6031 |
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