DAVID R PETERSON (M.D.) – Emergency Medicine Physician, NPI 1194742718
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,845 EMERGENCY MEDICINE in IL
Provider Addresses for DAVID R PETERSON (M.D.)
400 N Caldwell St
Staunton, IL 620881173
Phone: (618) 635-2200
Fax: (618) 635-3400
Type: Location
Corporate Boulevard, Lafayette, Lafayette Parish, Louisiana, 70502, United States
LAFAYETTE, LA 705083870
Phone: (800) 893-9698
Type: Mailing
HSHS Saint John's Hospital, 800, East Carpenter Street, Springfield, Sangamon County, Illinois, 62769, United States
SPRINGFIELD, IL 627690002
Phone: (217) 544-6464
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: 2004-02-05
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 |
|---|---|---|---|---|
| I20040205001208 | I | Emergency Medicine | IL | 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 62088)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Family Practice | IL | |
| Interventional Cardiology | MO | |
| - | IL | |
| Interventional Cardiology | IL | |
| Emergency Medicine | IN | |
| Nurse Practitioner | MO | |
| Physician Assistant | IL | |
| Family Practice, Emergency Medicine | IL | |
| Cardiovascular Disease (Cardiology) | IL |
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