TIMOTHY M PETERSON (MD) – Surgery Physician, NPI 1306055355

TIMOTHY M PETERSON (MD) is a healthcare provider. based in Litchfield, Minnesota. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. R6912 (IA). The NPI Number for TIMOTHY M PETERSON (MD) is 1306055355

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY M PETERSON (MD)
NPI
1306055355
Phone
(320) 693-3233
Address
520 SOUTH SIBLEY AVE
Enumeration Date
22 May 2007
Last Update Date
19 April 2011

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
3206933233
Graduation Year
1982 (44 years ago)
PAC ID
9436250099
Group Practice PAC ID
0840109740
Professional Enrollment ID
I20070726000205
Address ID
MN553553340LI612XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

730 GENERAL SURGERY in MN

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Provider Addresses for TIMOTHY M PETERSON (MD)

  • South Sibley Avenue, Litchfield, Meeker County, Minnesota, 55355, United States

    AFFILIATED COMMUNITY MEDICAL CENTERS

    LITCHFIELD, MN 55355

    Phone: (320) 693-3233

    Fax: (319) 384-6004

    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)

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: 2007-07-26

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
I20070726000205IGeneral SurgeryMNTBD

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 55355)

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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: 0840109740View full group profile
NameSpecialtyState
-MN
Nurse PractitionerMN
Nurse PractitionerWI
Nurse PractitionerIA
Nurse PractitionerMN
Obstetrics/Gynecology, General PracticeMN
-MN
Family PracticeMN
Family PracticeMN
Family PracticeMN

Reviews

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Frequently asked questions

How do payers reference TIMOTHY M PETERSON (MD)?
For TIMOTHY M PETERSON (MD), use NPI 1306055355 as the unique 10-digit identifier.
Is there an active status for TIMOTHY M PETERSON (MD)?
For scheduling context, TIMOTHY M PETERSON (MD) is shown as active in the registry.
How would a patient describe TIMOTHY M PETERSON (MD)'s focus?
For TIMOTHY M PETERSON (MD), the primary taxonomy reads as Surgery Physician. Clinical services aligned with this taxonomy classification.
Is TIMOTHY M PETERSON (MD) associated with Litchfield?
Public fields place TIMOTHY M PETERSON (MD) around Litchfield, Minnesota. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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