DR. PETER R NUTTLEMAN (MD) – Surgery Physician, NPI 1447204409
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,644 GENERAL SURGERY in TX
Provider Addresses for DR. PETER R NUTTLEMAN (MD)
6161 N State Highway 161 Ste 328
Irving, TX 750382220
Phone: (469) 283-1217
Fax: (972) 869-5990
Type: Location
260 26th St
Prairie Du Sac, WI 535782203
Phone: (608) 643-2431
Type: Location
6750 N MACARTHUR BLVD STE 160
IRVING, TX 750392517
Phone: (469) 283-1217
Type: Mailing
Sauk Prairie Healthcare, 260, 26th Street, Village of Prairie du Sac, Sauk County, Wisconsin, 53578, United States
PRAIRIE DU SAC, WI 535782203
Phone: (608) 643-2431
Type: Mailing
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: 2025-08-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20040427000279 | I | General Surgery | WI | TBD |
| I20250610001229 | I | General Surgery | OR | TBD |
| I20250807003709 | I | General Surgery | UT | 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 75038)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | WI | 45385 | Removal of polyps or growths of large bowel using an endoscope | 23 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OR | |
| Family Practice, Emergency Medicine | OR | |
| D E R M A T O L O G Y | RI | |
| Emergency Medicine | OR | |
| General Surgery | OR | |
| Emergency Medicine | OR | |
| - | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Nurse Practitioner | OR | |
| Family Practice | OR |
Reviews
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