JOHN PETERSON (M.D.) – Internal Medicine Physician, NPI 1003833625

JOHN PETERSON (M.D.) is a healthcare provider. based in Champaign, Illinois. specializing in Internal Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 036083081 (IL). The NPI Number for JOHN PETERSON (M.D.) is 1003833625

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
JOHN PETERSON (M.D.)
NPI
1003833625
Phone
(217) 344-2740
Address
2917 CROSSING CT
Enumeration Date
17 July 2006
Last Update Date
16 March 2019

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
0345154902
Professional Enrollment ID
I20040121000032
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for JOHN PETERSON (M.D.)

  • 2917, Crossing Court, Champaign, Champaign County, Illinois, 61822, United States

    SUITE B1

    CHAMPAIGN, IL 618226184

    Phone: (217) 344-2740

    Fax: (217) 344-2819

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-03-31 • Largest payer in this snapshot: Orexo US, Inc. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Orexo US, Inc.$14
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: 2004-01-21

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
I20040121000032IInternal MedicineILTBD

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 61822)

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Reviews

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Frequently asked questions

Where can patients find JOHN PETERSON (M.D.)'s NPI?
You can confirm JOHN PETERSON (M.D.) with NPI 1003833625; it appears in the national provider directory.
Is JOHN PETERSON (M.D.) active in the national directory?
JOHN PETERSON (M.D.)'s public NPI profile is in an active state.
Does JOHN PETERSON (M.D.) list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for JOHN PETERSON (M.D.). Clinical services aligned with this taxonomy classification.
Where does public data place JOHN PETERSON (M.D.)?
The snapshot lists Champaign, Illinois for JOHN PETERSON (M.D.); download NPPES for the complete set.
How can I contact JOHN PETERSON (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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