BRANDON JOSEPH PETERSON – Surgical Physician Assistant, NPI 1427643592

BRANDON JOSEPH PETERSON is a healthcare provider. based in Fort myers, Florida. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA9114114 (FL). The NPI Number for BRANDON JOSEPH PETERSON is 1427643592

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
BRANDON JOSEPH PETERSON
NPI
1427643592
Phone
(239) 936-6778
Address
3210 CLEVELAND AVE
Enumeration Date
1 March 2021
Last Update Date
17 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2393688277
Graduation Year
2020 (6 years ago)
PAC ID
6002223906
Group Practice PAC ID
5799676193
Professional Enrollment ID
I20210319001476
Address ID
FL339711309LE3400XBLVD343
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for BRANDON JOSEPH PETERSON

  • 3210 CLEVELAND AVE

    STE 100

    FORT MYERS, FL 339017182

    Phone: (239) 936-6778

    Type: Mailing

  • 19831 ADAMS RD

    FORT MYERS, FL 339084863

    Phone: (630) 386-0023

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $172.

Total Amount is formed as General ($172) + Research ($0) + Ownership ($0) = $172.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Bioventus LLC ($98).

Total Amount

$172

General + Research + Ownership

Payments

7

Total payment records

General Amount

$172

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-03-19

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
I20210319001476IPhysician AssistantFLTBD

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 33901)

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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: 5799676193View full group profile

Reviews

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Frequently asked questions

How is BRANDON JOSEPH PETERSON identified in CMS data?
CMS-hosted NPPES data lists BRANDON JOSEPH PETERSON with NPI 1427643592.
Is BRANDON JOSEPH PETERSON still practicing?
BRANDON JOSEPH PETERSON is currently listed as active in the public NPI registry.
What healthcare role does BRANDON JOSEPH PETERSON hold?
Scheduling teams often label BRANDON JOSEPH PETERSON under Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does BRANDON JOSEPH PETERSON list a practice location?
Patients near Fort Myers, Florida may find BRANDON JOSEPH PETERSON in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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