| Madeliene Alexandra Peterson, | |
|
170 N 1100 E, American Fork, UT 84003-2961 | |
| (801) 855-3300 | |
| Not Available |
| Full Name | Madeliene Alexandra Peterson |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Location | 170 N 1100 E, American Fork, Utah |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003698507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 12058297-3102 (Utah) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 12058297-4406 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| American Fork Hospital | American fork, UT | Hospital |
| Orem Community Hospital | Orem, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nph Anesthesia Of Utah Llc | 9537584313 | 91 |
| Entity Name | Nph Anesthesia of Utah LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366077273 PECOS PAC ID: 9537584313 Enrollment ID: O20200811001268 |
| Mailing Address | Practice Location Address |
|---|---|
| Madeliene Alexandra Peterson, 2221 Lakeside Blvd Ste 600, Richardson, TX 75082-4416 Ph: (469) 505-1652 | Madeliene Alexandra Peterson, 170 N 1100 E, American Fork, UT 84003-2961 Ph: (801) 855-3300 |
Kevin K Hair, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1014 E 220 N, American Fork, UT 84003 Phone: 801-763-5461 |
Preston Peterson Bird, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-492-1611 |
Mr. Michael Ryan Blaney, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-357-8818 |
Mrs. Vanessa Passanante, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-855-3267 Fax: 801-855-3251 |
Graham Brent Prime, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-763-3300 |
Dr. Nickolas Alexander Urban, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 170 N 1100 E, American Fork, UT 84003 Phone: 801-855-3625 |
Daniel William Bunker, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1159 E 200 N, #100, American Fork, UT 84003 Phone: 801-855-3372 |