GREGORY PETERSON (MD) – Dermatology Physician, NPI 1912385931

GREGORY PETERSON (MD) is a healthcare provider. based in Dallas, Texas. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. BP10052636 (TX). The NPI Number for GREGORY PETERSON (MD) is 1912385931

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
GREGORY PETERSON (MD)
NPI
1912385931
Phone
(214) 820-0111
Address
3500 GASTON AVE
Enumeration Date
11 May 2015
Last Update Date
13 June 2016

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Secondary Phone
2813635050
Graduation Year
2015 (11 years ago)
PAC ID
7113256298
Group Practice PAC ID
0042202947
Professional Enrollment ID
I20190916001553
Address ID
TX773803183TH9303XDRXX316
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,284 DERMATOLOGY in TX

Provider Addresses for GREGORY PETERSON (MD)

  • 3500 GASTON AVE

    DALLAS, TX 752462017

    Phone: (214) 820-0111

    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)

CMS reports 307 Open Payments records for all available years, with a total value of $6,282.

Total Amount is formed as General ($6,282) + Research ($0) + Ownership ($0) = $6,282.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($1,032).

Total Amount

$6,282

General + Research + Ownership

Payments

307

Total payment records

General Amount

$6,282

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-09-16

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
I20190916001553IDermatologyTXTBD

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
17003Destruction of precancer skin growth, 2-14 growths2,725476$0
17000Destruction of precancer skin growth, 1 growth678527$0
99213Established patient office or other outpatient visit, 20-29 minutes519423$0
17110Destruction of skin growth, 1-14 growths450376$0
99214Established patient office or other outpatient visit, 30-39 minutes408307$0
View full utilization report →

Insurance plans in this area (ZIP 75246)

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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: 0042202947View full group profile
NameSpecialtyState
D E R M A T O L O G YTX
D E R M A T O L O G YPA
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX
D E R M A T O L O G YTX

Reviews

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Frequently asked questions

Is there an official ID for GREGORY PETERSON (MD) in U.S. healthcare records?
The official identifier for GREGORY PETERSON (MD) is NPI 1912385931.
Active or inactive — what applies to GREGORY PETERSON (MD)?
You should see GREGORY PETERSON (MD) as active in CMS-hosted NPPES data.
How would a patient describe GREGORY PETERSON (MD)'s focus?
For GREGORY PETERSON (MD), the primary taxonomy reads as Dermatology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for GREGORY PETERSON (MD)?
Travel planning: use Dallas, Texas as the reference point for GREGORY PETERSON (MD), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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