BREANNA PETERSON (D.O.) – Emergency Medicine Physician, NPI 1013399112

BREANNA PETERSON (D.O.) is a healthcare provider. based in Saint louis, Missouri. specializing in Emergency Medicine Physician. They hold the professional credentials D.O.. They hold a License No. 66330 (MN). The NPI Number for BREANNA PETERSON (D.O.) is 1013399112

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
BREANNA PETERSON (D.O.)
NPI
1013399112
Phone
(314) 966-9491
Address
2345 Dougherty Ferry Rd
Enumeration Date
24 June 2015
Last Update Date
12 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6126726999
Graduation Year
2015 (11 years ago)
PAC ID
7911204508
Group Practice PAC ID
1951213057
Professional Enrollment ID
I20190920001035
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:10State licenses:2Digital endpointsOther names

Provider Addresses for BREANNA PETERSON (D.O.)

  • 2345 Dougherty Ferry Rd

    Saint Louis, MO 631223313

    Phone: (314) 966-9491

    Type: Location

  • 400 STINSON BLVD

    MINNEAPOLIS, MN 554132614

    Phone:

    Type: Mailing

  • 911 NORTHLAND DR

    PRINCETON, MN 55371

    Phone: (763) 389-1313

    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: 2019-09-20

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
I20190920001035IEmergency MedicineMNTBD

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
99284Emergency department visit with moderate level of medical decision making8381$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6960$0
99285Emergency department visit with high level of medical decision making5150$0
99283Emergency department visit with low level of medical decision making3030$0
View full utilization report →

Insurance plans in this area (ZIP 63122)

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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: 1951213057View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm BREANNA PETERSON (D.O.)'s NPI?
Yes. BREANNA PETERSON (D.O.) is listed with NPI 1013399112 in the public NPI dataset.
Does the file indicate BREANNA PETERSON (D.O.) is practicing under active NPI?
Directory data currently reports BREANNA PETERSON (D.O.) as active.
What healthcare role does BREANNA PETERSON (D.O.) hold?
Scheduling teams often label BREANNA PETERSON (D.O.) under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for BREANNA PETERSON (D.O.)?
BREANNA PETERSON (D.O.)'s geographic hint is Saint Louis, Missouri in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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