STEPHEN PAUL PETERSON (MD) – Family Medicine Physician, NPI 1629127915
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,050 FAMILY PRACTICE in WI
Provider Addresses for STEPHEN PAUL PETERSON (MD)
146 E Geneva Sq
Lake Geneva, WI 531479694
Phone: (262) 249-5000
Type: Location
PO BOX 604337
CHARLOTTE, NC 282604337
Phone: (919) 238-2000
Fax: (919) 238-5010
Type: Mailing
8300 HEALTH PARK STE 107
RALEIGH, NC 276154731
Phone: (919) 238-2000
Fax: (919) 238-5010
Type: Location
146, East Geneva Square, Lake Geneva, Walworth County, Wisconsin, 53147, United States
LAKE GENEVA, WI 531479694
Phone: (262) 249-5000
Type: Location
501, Pheasant Ridge Lane, Fontana-on-Geneva Lake, Walworth County, Wisconsin, 53125, United States
FONTANA, WI 531251491
Phone: (262) 275-5663
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: 2019-11-04
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191104001814 | I | Family Practice | NC | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 160 | 94 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 92 | 69 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 70 | 70 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 17 | 11 | $0 |
| G0008 | Administration of influenza virus vaccine | 14 | 14 | $0 |
Insurance plans in this area (ZIP 53147)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | WI | 90670 | Pneumococcal vaccine for injection into muscle | 52 | 52 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | VA | |
| - | NY | |
| Nurse Practitioner | MI | |
| Family Practice | TX | |
| Physician Assistant | NC | |
| Internal Medicine, Geriatric Medicine | NC | |
| Qualified Speech Language Pathologist | OK | |
| Occupational Therapist In Private Practice | NC | |
| Internal Medicine | NC | |
| Internal Medicine | NC |
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