DR. THOMAS G PETERSON (O.D.) – Optometrist, NPI 1114043387

DR. THOMAS G PETERSON (O.D.) is a healthcare provider. based in Shawano, Wisconsin. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 2324 (WI). The NPI Number for DR. THOMAS G PETERSON (O.D.) is 1114043387

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. THOMAS G PETERSON (O.D.)
NPI
1114043387
Phone
(715) 526-3163
Address
150A COUNTY ROAD B
Enumeration Date
21 March 2007
Last Update Date
22 July 2018

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
7156233620
Graduation Year
1989 (37 years ago)
PAC ID
5395876817
Group Practice PAC ID
1456684471
Professional Enrollment ID
I20100628000647
Address ID
WI544092912AN2325XRDXX300
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

798 OPTOMETRY in WI

Provider Addresses for DR. THOMAS G PETERSON (O.D.)

  • 150A COUNTY ROAD B

    SHAWANO, WI 541667072

    Phone: (715) 526-3163

    Fax: (715) 526-4019

    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)

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: 2010-06-28

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
I20100628000647IOptometryWITBD

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
99214Established patient office or other outpatient visit, 30-39 minutes139127$0
92250Photography of the retina4747$0
99213Established patient office or other outpatient visit, 20-29 minutes3225$0
92134Imaging of retina3128$0
92133Imaging of optic nerve3030$0
View full utilization report →

Insurance plans in this area (ZIP 54166)

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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: 1456684471View full group profile

Reviews

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Frequently asked questions

What identifier follows DR. THOMAS G PETERSON (O.D.) across health systems?
The NPI 1114043387 uniquely identifies DR. THOMAS G PETERSON (O.D.) in U.S. healthcare data.
Does the public listing show DR. THOMAS G PETERSON (O.D.) as active?
DR. THOMAS G PETERSON (O.D.)'s NPI record reflects an active status in NPPES.
How should patients interpret DR. THOMAS G PETERSON (O.D.)'s specialty?
The extract shows Optometrist for DR. THOMAS G PETERSON (O.D.). Clinical services aligned with this taxonomy classification.
Which community is linked to DR. THOMAS G PETERSON (O.D.)?
DR. THOMAS G PETERSON (O.D.) shows a connection to Shawano, Wisconsin in registry-derived data.
Can I export DR. THOMAS G PETERSON (O.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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