ANTHONY MICHAEL PETERSEN (M.D.) – Psychiatry Physician, NPI 1336407790
Psychiatry Physician
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NPPES metrics only — not quality of care.
256 PSYCHIATRY in UT
Provider Addresses for ANTHONY MICHAEL PETERSEN (M.D.)
630 Medical Dr
Bountiful, UT 840104908
Phone: (801) 299-3781
Fax: (801) 299-2416
Type: Location
145 W 200 N Ste 600
Provo, UT 846013016
Phone: (801) 821-2781
Fax: (801) 901-1194
Type: Location
3300 N Triumph Blvd Ste 500
Lehi, UT 840436475
Phone: (801) 821-2781
Fax: (801) 901-1194
Type: Location
2132 N Robins Dr Ste 300
Layton, UT 840417077
Phone: (801) 821-2781
Fax: (801) 901-1194
Type: Location
2225 S WILMINGTON CIR
SALT LAKE CITY, UT 841091228
Phone: (801) 603-2208
Type: Mailing
UNIVERSITY OF UTAH PSYCHIATRY DEPARTMENT
50 NORTH MEDICAL DRIVE
SALT LAKE CITY, UT 841320001
Phone: (801) 581-7951
Type: Location
630 MEDICAL DR
BOUNTIFUL, UT 840104908
Phone: (801) 299-3781
Fax: (801) 299-2416
Type: Location
6550 S MILLROCK DR STE 250
SALT LAKE CITY, UT 841212331
Phone: (801) 821-2613
Type: Mailing
PO BOX 742353
ATLANTA, GA 303742353
Phone:
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: 2016-09-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160902001726 | I | Psychiatry | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90870 | Therapy using electrical currents | 106 | 11 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 53 | 23 | $0 |
Insurance plans in this area (ZIP 84010)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| P S Y C H I A T R Y | UT | |
| P S Y C H I A T R Y | GA | |
| P S Y C H I A T R Y | GA | |
| Psychiatry, Neurology | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | ID | |
| P S Y C H I A T R Y | ID | |
| P S Y C H I A T R Y | UT |
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