LENNETT PETERSEN (APRN) – Nurse Practitioner, NPI 1104425073
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
761 NURSE PRACTITIONER in AK
Provider Addresses for LENNETT PETERSEN (APRN)
3801 LAKE OTIS PKWY STE 300
ANCHORAGE, AK 995085234
Phone: (907) 562-2277
Fax: (907) 563-3460
Type: Mailing
3200 Providence Dr
Anchorage, AK 995084615
Phone: (907) 854-9333
Type: Location
10928 Eagle River Rd Ste 240
Eagle River, AK 995778080
Phone: (907) 562-2277
Fax: (907) 563-3460
Type: Location
7010 E Bogard Rd Bldg 2
Wasilla, AK 996544711
Phone: (907) 373-4732
Type: Location
670 W FIREWEED LN STE 160
ANCHORAGE, AK 995032561
Phone:
Type: Mailing
3200 PROVIDENCE DR
ANCHORAGE, AK 995084615
Phone: (907) 854-9333
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $352.
Total Amount is formed as General ($352) + Research ($0) + Ownership ($0) = $352.
Last reported payment date: 2024-08-21 • Largest payer in this snapshot: Medtronic, Inc. ($257).
Total Amount
$352
General + Research + Ownership
Payments
10
Total payment records
General Amount
$352
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $257 |
| PFIZER INC. | $40 |
| ABBVIE INC. | $29 |
| Collegium Pharmaceutical, Inc. | $13 |
| Averitas Pharma Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-05-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210505002830 | I | Nurse Practitioner | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 99508)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Occupational Therapist In Private Practice | AK | |
| Physician Assistant | AK | |
| Orthopedic Surgery | AK | |
| P O D I A T R Y | TX | |
| Family Practice | WA | |
| Physician Assistant | AK | |
| - | AK | |
| Family Practice, Osteopathic Manipulative Medicine | AK | |
| Pain Management, Physical Medicine And Rehabilitation | AK | |
| Physical Therapist In Private Practice | AK |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.