BRYAN J PETERSON (CRNA) – Anesthesiology Physician, NPI 1578574489

BRYAN J PETERSON (CRNA) is a healthcare provider. based in Ogden, Utah. specializing in Anesthesiology Physician. They hold the professional credentials CRNA. They hold a License No. 96-321407-1205 (UT). The NPI Number for BRYAN J PETERSON (CRNA) is 1578574489

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
BRYAN J PETERSON (CRNA)
NPI
1578574489
Phone
(800) 880-3566
Address
5475 S 500 E
Enumeration Date
10 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
8014792111
Graduation Year
1986 (40 years ago)
PAC ID
7810956182
Group Practice PAC ID
6305809492
Professional Enrollment ID
I20041004000863
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

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Provider Addresses for BRYAN J PETERSON (CRNA)

  • Ogden Regional Medical Center, 5475, Adams Avenue Parkway, Stonegate, Washington Terrace, Weber County, Utah, 84405, United States

    OGDEN, UT 844056905

    Phone: (800) 880-3566

    Fax: (801) 733-5872

    Type: Location

  • 1954 FORT UNION BLVD STE 106

    SALT LAKE CITY, UT 841216890

    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: 2004-10-04

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
I20041004000863IAnesthesiologyUTTBD

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
64447Injection of anesthetic agent and/or steroid into thigh nerve (femoral nerve)1111$0
View full utilization report →

Insurance plans in this area (ZIP 84405)

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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: 6305809492View full group profile

Reviews

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Frequently asked questions

Where can patients find BRYAN J PETERSON (CRNA)'s NPI?
You can confirm BRYAN J PETERSON (CRNA) with NPI 1578574489; it appears in the national provider directory.
Is BRYAN J PETERSON (CRNA)'s NPI currently valid?
The extract we use shows BRYAN J PETERSON (CRNA) as active.
What field does BRYAN J PETERSON (CRNA) work in?
You can think of BRYAN J PETERSON (CRNA) as practicing within Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place BRYAN J PETERSON (CRNA)?
The snapshot lists Ogden, Utah for BRYAN J PETERSON (CRNA); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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