CHRISTINE L PETERSEN (MD) – Diagnostic Radiology Physician, NPI 1578554044
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CHRISTINE L PETERSEN (MD)
22 Bramhall St
Portland, ME 041023134
Phone: (207) 662-4735
Type: Location
324 GANNETT DR STE 200
SOUTH PORTLAND, ME 041063266
Phone: (207) 482-7800
Type: Mailing
22 BRAMHALL ST
PORTLAND, ME 041023134
Phone: (207) 662-4735
Type: Location
Lifetime Center For Family Health, 630, Plantation Street, Worcester, Worcester County, Massachusetts, 01605, United States
WOT 12TH FL
WORCESTER, MA 016052038
Phone: (508) 852-0600
Type: Mailing
135, Gold Star Boulevard, Chadwick Square, Worcester, Worcester County, Massachusetts, 01606, United States
WORCESTER, MA 016062738
Phone: (508) 853-2716
Fax: (508) 854-0479
Type: Location
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Fax: (508) 334-1977
Type: Mailing
55 LAKE AVE N
WORCESTER, MA 016550002
Phone: (508) 334-3850
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: 2022-05-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040728001447 | I | Diagnostic Radiology | MA | TBD |
| I20220527001575 | I | Diagnostic Radiology | ME | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 449 | 449 | $0 |
| 77063 | Screening 3d breast mammography | 447 | 447 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 153 | 145 | $0 |
| 77065 | Diagnostic mammography of 1 breast | 113 | 101 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 103 | 101 | $0 |
Insurance plans in this area (ZIP 04102)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| - | MA | |
| Emergency Medicine | NC |
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