DR. GREGORY N. PETERSON (MD) – Psychiatry Physician, NPI 1619916962

DR. GREGORY N. PETERSON (MD) is a healthcare provider. based in West hartford, Connecticut. specializing in Psychiatry Physician. They hold the professional credentials MD. They hold a License No. 036498 (CT). The NPI Number for DR. GREGORY N. PETERSON (MD) is 1619916962

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. GREGORY N. PETERSON (MD)
NPI
1619916962
Phone
(860) 262-5964
Address
47 WALKLEY RD
Enumeration Date
5 June 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037357481
Graduation Year
1995 (31 years ago)
PAC ID
9830175736
Group Practice PAC ID
2567367469
Professional Enrollment ID
I20040629001179
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. GREGORY N. PETERSON (MD)

  • 47, Walkley Road, West Hill Historic District, Fernridge Place, West Hartford, Capitol Planning Region, Connecticut, 06119, United States

    WEST HARTFORD, CT 06119

    Phone: (860) 262-5964

    Type: Mailing

  • 1000, Silver Street, Middletown, Middlesex County, Connecticut, 06457, United States

    MIDDLETOWN, CT 06457

    Phone: (860) 262-5868

    Fax: (860) 262-5850

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-06-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040629001179IPsychiatryCTTBD

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.

Verify on CMS Revalidation Lookup Tool

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 06119)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567367469View full group profile
NameSpecialtyState
-CT
Mental Health CounselorCT
P S Y C H I A T R YCT
-MA
Marriage And Family TherapistCT
Mental Health CounselorCT
Mental Health CounselorCT
-CT
-CT
Nurse PractitionerFL

Reviews

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Frequently asked questions

What federal number belongs to DR. GREGORY N. PETERSON (MD)?
The federal identifier for DR. GREGORY N. PETERSON (MD) is NPI 1619916962.
Is DR. GREGORY N. PETERSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. GREGORY N. PETERSON (MD) treat or focus on?
Patients typically see DR. GREGORY N. PETERSON (MD) under the specialty Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does DR. GREGORY N. PETERSON (MD) practice in Connecticut?
You will see West Hartford, Connecticut on file for DR. GREGORY N. PETERSON (MD) alongside any extra practice locations.
Is DR. GREGORY N. PETERSON (MD) a real provider?
This page reflects official NPPES data for NPI 1619916962. Always confirm identity and privileges with the practice and licensing boards.

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