LANCE PETERSEN (MD) – Family Medicine Physician, NPI 1245303429

LANCE PETERSEN (MD) is a healthcare provider. based in Afton, Wyoming. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. MD00035749 (WA). The NPI Number for LANCE PETERSEN (MD) is 1245303429

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
LANCE PETERSEN (MD)
NPI
1245303429
Phone
(307) 885-5800
Address
110 Hospital Lane
Enumeration Date
16 November 2006
Last Update Date
22 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7016622131
Graduation Year
1995 (31 years ago)
PAC ID
3072401959
Group Practice PAC ID
9537128681
Professional Enrollment ID
I20241012000253
Address ID
ND583012719DE1031XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness85
Years active:19State licenses:2Digital endpointsOther names

328 FAMILY PRACTICE in WY

Provider Addresses for LANCE PETERSEN (MD)

  • 110 Hospital Lane

    Afton, WY 831100579

    Phone: (307) 885-5800

    Fax: (307) 885-5865

    Type: Location

  • Powell Hospital, 777, Avenue H, Powell, Park County, Wyoming, 82435, United States

    POWELL, WY 824352260

    Phone: (307) 754-2267

    Fax: (307) 754-7747

    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: 2024-10-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20040310001154IFamily PracticeWATBD
I20241012000253IFamily PracticeNDTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83110)

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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: 9537128681View full group profile
NameSpecialtyState
Internal MedicineOH
Internal Medicine, HospitalistWV
Emergency MedicineND
Emergency MedicineMI
Nurse PractitionerND
Internal Medicine, HospitalistKY
-ND
-ND
Family PracticeFL

Reviews

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Frequently asked questions

What number should I use to identify LANCE PETERSEN (MD) for billing?
Administrative and clinical systems typically use NPI 1245303429 for LANCE PETERSEN (MD).
Should I treat LANCE PETERSEN (MD) as an active provider?
Patients and plans typically see LANCE PETERSEN (MD) as active in the national extract.
What does the directory say LANCE PETERSEN (MD) does?
Insurance directories may phrase it differently, but here LANCE PETERSEN (MD) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is LANCE PETERSEN (MD) tied to Afton, Wyoming?
If you are local to Afton, Wyoming, LANCE PETERSEN (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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