Dr Nicolas Lee Peters, MD - Medicare Pediatrics in Gallup, NM

Dr Nicolas Lee Peters, MD is a medicare enrolled "Pediatrics" physician in Gallup, New Mexico. His current practice location is 2111 College Dr, Gallup, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 863-1820.

Dr Nicolas Lee Peters is licensed to practice in New Mexico (license number MD2017-0087) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487844791.

Contact Information

Dr Nicolas Lee Peters, MD
2111 College Dr,
Gallup, NM 87301-5600
(505) 863-1820
Not Available



Physician's Profile

Full NameDr Nicolas Lee Peters
GenderMale
SpecialityPediatrics
Location2111 College Dr, Gallup, New Mexico
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487844791
  • Provider Enumeration Date: 08/01/2007
  • Last Update Date: 02/05/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 6608023130
  • Enrollment ID: I20120905000699

Medical Identifiers

Medical identifiers for Dr Nicolas Lee Peters such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487844791NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 35.094612 (Ohio)Secondary
208000000XPediatrics 48190 (Arizona)Secondary
2080P0207XPediatrics - Pediatric Hematology-oncology 35.094612 (Ohio)Secondary
2080P0207XPediatrics - Pediatric Hematology-oncology 48190 (Arizona)Secondary
208M00000XHospitalist MD2017-0087 (New Mexico)Secondary
208M00000XHospitalist 48190 (Arizona)Secondary
246QM0706XSpecialist/technologist, Pathology - Medical Technologist (* (Not Available))Secondary
208000000XPediatrics MD2017-0087 (New Mexico)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nicolas Lee Peters allows following entities to bill medicare on his behalf.
Entity NamePediatric Academic Association, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063419943
PECOS PAC ID: 2961306774
Enrollment ID: O20031124000198

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Entity NameMuskingum Valley Health Centers
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205018348
PECOS PAC ID: 4789760216
Enrollment ID: O20080618000216

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Entity NamePediatrix Medical Group Of Ohio Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467559179
PECOS PAC ID: 2365672730
Enrollment ID: O20140304000984

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicolas Lee Peters is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Nicolas Lee Peters, MD
70 S Val Vista Dr Ste A3-618,
Gilbert, AZ 85296-0942

Ph: (480) 485-5166
Dr Nicolas Lee Peters, MD
2111 College Dr,
Gallup, NM 87301-5600

Ph: (505) 863-1820

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Pediatrics Doctors in Gallup, NM

Dr. Carlos Manuel De Sanctis, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301
Phone: 505-722-1000    Fax: 505-722-1268
Ramona V. Anderson, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 516 East Nizhoni Blvd., Gallup, NM 87301
Phone: 505-722-1000    Fax: 505-722-1268
Dr. John Edward Ratmeyer, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301
Phone: 505-722-1000    Fax: 505-722-1268
Michelle Stam-maclaren, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 2111 College Drive, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301
Phone: 505-863-1820    
Janet M Li-tempest, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301
Phone: 505-722-1000    Fax: 505-722-1268
Gary A Escudero, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 516 E. Nizhoni Blvd, Box 1337, Gallup, NM 87301
Phone: 505-722-1000    Fax: 505-722-1397
Dr. Gayle Ann Harrison, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 2111 College Dr, Gallup, NM 87301
Phone: 505-863-1820    Fax: 505-863-1898

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