ANNA MARIE PETERSEN FNP-BC
NPI 1174245021
Nurse Practitioner - Primary Care in South Lake Tahoe, CA
NPI Status: Active since September 16, 2022
Contact Information
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA
ZIP 96150
Phone: (530) 543-5623
- Individual
- Female
- Nurse Practitioner
- Primary Care
- PECOS Enrolled
About ANNA PETERSEN
This page provides the complete NPI Profile along with additional information for Anna Petersen, a provider established in South Lake Tahoe, California with a medical specialization in Nurse Practitioner, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1174245021 assigned on September 2022. The practitioner's primary taxonomy code is 363LP2300X with license number 95022656 (CA). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1174245021
- Provider Name
- ANNA MARIE PETERSEN FNP-BC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150
- Location Phone
- (530) 543-5623
- Mailing Address
- 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 09-16-2022
- Last Update Date
- 09-16-2022
- Code Navigator
A nurse practitioner (NP) like Anna Petersen is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Primary Care
- Taxonomy Code
- 363LP2300X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 95022656
- License State
- CA
Medicare Participation & PECOS Enrollment Status
Anna Petersen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 96150 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $92.61
- Minimum New Patient Price $60.44
- Maximum New Patient Price $180.85
- Average New Patient Copayment $23.15
- Minimum New Patient Copayment $15.11
- Maximum New Patient Copayment $45.21
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.95
- Minimum Established Patient Price $19.88
- Maximum Established Patient Price $148.15
- Average Established Patient Copayment $26.48
- Minimum Established Patient Copayment $4.97
- Maximum Established Patient Copayment $37.03
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 2 | 4 | 5 | 0 | 2 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 4 | 4 | 10 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 4 + 4 + 1 + 0 + 0 + 4 + 24 = 49 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 49 = 1 | 1 | ||||||||
The NPI number 1174245021 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1609933910 | EVE-MARIE WELCH PA Individual | Physician Assistant | 2201 SOUTH AVE STE B SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1457659807 | BARTON HEALTHCARE SYSTEM Organization | Clinic/Center (Rural Health) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1194709824 | CATHERINE GAEHWILER PA Individual | Physician Assistant | 2201 SOUTH AVE STE B SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1730351636 | MARY JEAN JONES NP Individual | Nurse Practitioner | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1235129289 | TODD WILLIAM DEGIOVANNI PA-C Individual | Physician Assistant | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1699187849 | TESSA DAHLEN AMOS NP-C Individual | Nurse Practitioner (Family) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1134558000 | JACQUELYN NOEL SARTORIUS PA-C Individual | Physician Assistant | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1710984075 | DR. JENNIFER ANN EHMANN MD Individual | Pediatrics | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1700975976 | DAVID M K I LIU MD, PHD Individual | Pediatrics | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1619169653 | ELIZABETH ANNE GLASS LCSW Individual | Social Worker (Clinical) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1902327992 | LAURA STEVENS LCSW Individual | Social Worker (Clinical) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1477022358 | DREW N HERBERT FNP Individual | Nurse Practitioner (Family) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1225036445 | DR. PAUL WILLIAM RORK MD Individual | Family Medicine | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1548607955 | BROOKE M PANCIO MD Individual | Family Medicine | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1144214495 | DR. MATTHEW PAUL WONNACOTT MD Individual | Family Medicine | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1962746065 | KIMBERLY ANGELA VANKIRK LCSW Individual | Social Worker (Clinical) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1053310326 | BARTON HEALTHCARE SYSTEM Organization | Clinic/Center (Rural Health) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1548897119 | AUDREY JEAN DASILVA Individual | Pediatrics | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5550 |
| 1962251579 | JOHN BARRETT ROSS FNP Individual | Nurse Practitioner (Family) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
| 1558600122 | ELKE ANNE HOUSER FNP-C, ENP-C, RN, Individual | Nurse Practitioner (Family) | 2201 SOUTH AVE SOUTH LAKE TAHOE, CA 96150 (530) 543-5623 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174245021, enumerated in the NPI registry as an "individual" on September 16, 2022
The provider is located at 2201 South Ave South Lake Tahoe, Ca 96150 and the phone number is (530) 543-5623
The provider's speciality is Nurse Practitioner with taxonomy code 363LP2300X with a focus in Primary Care
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $92.61 with an average copayment of $23.15 for new patient appointments. Established patients should expect a typical charge of $105.95 and an average copayment of 26.48. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on September 16, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.