SCOTT M PETERSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1053303123

SCOTT M PETERSON (CRNA) is a healthcare provider. based in Apple valley, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. R 121227-9 (MN). The NPI Number for SCOTT M PETERSON (CRNA) is 1053303123

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
SCOTT M PETERSON (CRNA)
NPI
1053303123
Phone
Not provided
Address
13330 GREENWICH CT
Enumeration Date
16 August 2005
Last Update Date
16 May 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6122734097
Graduation Year
1997 (29 years ago)
PAC ID
3577500644
Group Practice PAC ID
7315986064
Professional Enrollment ID
I20050412000107
Address ID
MN554541450MI2450XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

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Provider Addresses for SCOTT M PETERSON (CRNA)

  • 13330, Greenwich Court, Hallwood Highlands, Apple Valley, Dakota County, Minnesota, 55124, United States

    APPLE VALLEY, MN 551247620

    Phone:

    Type: Mailing

  • 8990, Springbrook Drive Northwest, Parkside, Coon Rapids, Anoka County, Minnesota, 55433, United States

    STE 250

    COON RAPIDS, MN 554335850

    Phone: (763) 398-0099

    Fax: (763) 398-0124

    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: 2005-04-12

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
I20050412000107ICertified Registered Nurse Anesthetist (Crna)MNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00104Anesthesia for electroshock therapy2513$0
View full utilization report →

Insurance plans in this area (ZIP 55124)

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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: 7315986064View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YPA
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
A N E S T H E S I O L O G YMN
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YIA
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
Certified Registered Nurse Anesthetist (Crna)MN

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Frequently asked questions

Is SCOTT M PETERSON (CRNA) listed with a National Provider Identifier?
Yes — SCOTT M PETERSON (CRNA) has NPI 1053303123 on file in the registry.
Would SCOTT M PETERSON (CRNA) appear as active to a payer?
You can treat SCOTT M PETERSON (CRNA) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for SCOTT M PETERSON (CRNA)?
At a glance, SCOTT M PETERSON (CRNA) is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for SCOTT M PETERSON (CRNA)?
Travel planning: use Apple Valley, Minnesota as the reference point for SCOTT M PETERSON (CRNA), then confirm.
Can I trust this NPI listing for SCOTT M PETERSON (CRNA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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