SELENA B PETERS (MD) – Anesthesiology Physician, NPI 1063426880

SELENA B PETERS (MD) is a healthcare provider. based in Northbrook, Illinois. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 36166538 (WI). The NPI Number for SELENA B PETERS (MD) is 1063426880

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
SELENA B PETERS (MD)
NPI
1063426880
Phone
(866) 729-1012
Address
40 SKOKIE BLVD STE 300
Enumeration Date
28 July 2006
Last Update Date
4 June 2024

Doctor Profile

Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Secondary Phone
7733555300
Graduation Year
2006 (20 years ago)
PAC ID
8729273602
Group Practice PAC ID
9436119542
Professional Enrollment ID
I20241224000075
Address ID
IL600184962RO9550XRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,631 ANESTHESIOLOGY in IL

Provider Addresses for SELENA B PETERS (MD)

  • 40 SKOKIE BLVD STE 300

    NORTHBROOK, IL 600621601

    Phone: (866) 729-1012

    Fax: (847) 996-2147

    Type: Location

  • West Innovation Drive, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States

    SUITE 300

    MILWAUKEE, WI 532264837

    Phone: (414) 456-5006

    Type: Mailing

  • 9000, West Wisconsin Avenue, Cannon Park, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States

    PEDIATRIC ANESTHESIOLOGY

    MILWAUKEE, WI 532264874

    Phone: (414) 266-3560

    Fax: (414) 266-6092

    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: 2024-12-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20111213000808IAnesthesiologyHITBD
I20241224000075IAnesthesiologyILTBD

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 60062)

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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: 9436119542View full group profile
NameSpecialtyState
Pain Management, Anesthesiology, Interventional Pain ManagementIL
A N E S T H E S I O L O G YIL
Anesthesiology, Pain ManagementIN
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL
Anesthesiology, Interventional Pain ManagementIL
A N E S T H E S I O L O G YIL
A N E S T H E S I O L O G YIL

Reviews

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Frequently asked questions

Is there an official ID for SELENA B PETERS (MD) in U.S. healthcare records?
The official identifier for SELENA B PETERS (MD) is NPI 1063426880.
Is there an active status for SELENA B PETERS (MD)?
For scheduling context, SELENA B PETERS (MD) is shown as active in the registry.
What clinical focus is listed for SELENA B PETERS (MD)?
At a glance, SELENA B PETERS (MD) is tied to Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Is SELENA B PETERS (MD) located near Northbrook?
SELENA B PETERS (MD) currently maps to Northbrook, Illinois in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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