MS. LUCY ELIZABETH PETERSON (M.D.) – Plastic Surgery Physician, NPI 1790776425
Plastic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
147 PLASTIC AND RECONSTRUCTIVE SURGERY in WA
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Provider Addresses for MS. LUCY ELIZABETH PETERSON (M.D.)
105, West 8th Avenue, Spokane, Spokane County, Washington, 99201, United States
STE 500
SPOKANE, WA 992042302
Phone: (509) 838-3937
Fax: (509) 624-6232
Type: Mailing
PO BOX 8168
SPOKANE, WA 992030168
Phone: (509) 838-3937
Type: Mailing
907 S PERRY ST
SPOKANE, WA 992023462
Phone: (509) 838-3937
Type: Location
11141 Parkview Plaza Dr Ste 300
Fort Wayne, IN 468451715
Phone: (260) 425-6960
Fax: (260) 425-6965
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: 2007-06-11
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 |
|---|---|---|---|---|
| I20070611000153 | I | Plastic And Reconstructive Surgery | WA | 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 99204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| - | IL | |
| O P H T H A L M O L O G Y | OR | |
| O P H T H A L M O L O G Y | WA | |
| Nurse Practitioner | WA | |
| Family Practice | WA | |
| Interventional Radiology, Diagnostic Radiology | OH | |
| Physician Assistant | ID | |
| Clinical Psychologist | WA |
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