DAVID ARTHUR PETERSON PT
NPI 1215971627
Physical Therapist in Port Washington, WI
NPI Status: Active since June 15, 2006
Contact Information
1317 W GRAND AVE
PORT WASHINGTON, WI
ZIP 53074
Phone: (262) 284-2261
- Individual
- Male
- Years of Experience 39
- Physical Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About DAVID PETERSON
This page provides the complete NPI Profile along with additional information for David Peterson, a provider established in Port Washington, Wisconsin with a medical specialization in Physical Therapist and more than 39 years of experience. The healthcare provider is registered in the NPI registry with number 1215971627 assigned on June 2006. The practitioner's primary taxonomy code is 225100000X with license number 3553 (WI). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1215971627
- Provider Name
- DAVID ARTHUR PETERSON PT
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1317 W GRAND AVE PORT WASHINGTON, WI 53074
- Location Phone
- (262) 284-2261
- Mailing Address
- W66N764 MADISON AVE CEDARBURG, WI 53012
- Mailing Phone
- (262) 376-9175
- Medical School Name
- OTHER
- Graduation Year
- 1987
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-15-2006
- Last Update Date
- 07-08-2007
- Code Navigator
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
Physical Therapist
- Taxonomy Code
- 225100000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- License No.
- 3553
- License State
- WI
- Taxonomy Description
- Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Standard (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus (No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
David Peterson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
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.
PECOS PAC ID: 9335239292
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20071214000548
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $16.84 for an established patient copayment.
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 53074 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $67.37
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $16.84
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* 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 | 2 | 1 | 5 | 9 | 7 | 1 | 6 | 2 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 2 | 5 | 18 | 7 | 2 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 2 + 5 + 1 + 8 + 7 + 2 + 6 + 4 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1215971627 is valid because the calculated check digit 7 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 |
|---|---|---|---|
| 1497716880 | JOHN P BONAVIA MD Individual | Family Medicine | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 268-6998 |
| 1407809882 | MRS. KIMBERLY BURNS KLUG PT Individual | Physical Therapist | 1317 W GRAND AVE LAKE HILLS MEDICAL COMPLEX PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1184678740 | MS. DEANNE MARIE HAUCH ATC Individual | Specialist/Technologist (Athletic Trainer) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1861446320 | BETSY A KENDZIORSKI LCSW Individual | Social Worker (Clinical) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1346294816 | TIMOTHY J SHININGER LCSW LMFT Individual | Social Worker (Clinical) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1407803489 | SANDRA E BLACK LCSW Individual | Social Worker (Clinical) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1265479257 | DENNIS J ANDERSON LCSW CADCIII Individual | Social Worker (Clinical) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1467499434 | MRS. KATHLEEN ELEANOR CHIER P.T. Individual | Physical Therapist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1104864776 | MRS. KATHLEEN NOETZEL MS CCC-SLP Individual | Speech-Language Pathologist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1912947391 | KIM M GRISAR PTA Individual | Physical Therapy Assistant | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1154365336 | MRS. TERESA LIN BRAUN MS, CCC-SLP Individual | Speech-Language Pathologist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1770599953 | DR. JEFFREY JOSEPH BONGIORNO DPM Individual | Podiatrist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-8800 |
| 1821005406 | JACQUELINE WEEDEN LCSW Individual | Social Worker | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1144232125 | MS. KIM MARIE RASMUSSEN OTR Individual | Occupational Therapist (Pediatrics) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1003955972 | NEAL Z. POTASH MS Individual | Social Worker | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1104373323 | MARCY DRUMMY MS, LPC Individual | Counselor (Professional) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1134677669 | BONNIE HALPER LPC Individual | Counselor (Professional) | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-5789 |
| 1497049969 | FOREFRONT DERMATOLOGY, S.C. Organization | Dermatology | 1317 W GRAND AVE SUITE 5 PORT WASHINGTON, WI 53074 (920) 683-5278 |
| 1497645253 | CIARA WARDENBURG DPT Individual | Physical Therapist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
| 1548150022 | KELLIE ANN ARMISTEAD OTR/L Individual | Occupational Therapist | 1317 W GRAND AVE PORT WASHINGTON, WI 53074 (262) 284-2261 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215971627, enumerated in the NPI registry as an "individual" on June 15, 2006
The provider is located at 1317 W Grand Ave Port Washington, Wi 53074 and the phone number is (262) 284-2261
The provider's speciality is Physical Therapist with taxonomy code 225100000X
The provider has more than 39 years of experience.
The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on June 15, 2006. 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.