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Active NPI 1508860487 Individual Practitioner Male Practitioner

Dr. Jack T Peterson , MD

Specialist • Topeka, KS

Professional Overview & Biography Verified Profile Summary

Dr. Jack Peterson, MD is a certified Specialist practicing in Topeka, KS. With approximately 43 years of clinical experience since graduating from Baylor College Of Medicine in 1983, Dr. Peterson delivers high-quality medical care to the local community at 631 SW HORNE ST.

Dr. Peterson does not directly accept Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

631 Sw Horne St
Ste 400

Topeka, KS 666061661

Telephone 7852349000
Fax 7852349119
Associated Practice Facility / Clinic
🏢 Im/id Medical Consultants Facility NPI 1023015047

Medicare Profile & Education

Medical School

Baylor College Of Medicine

Graduation Year

1983

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Topeka, KS

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
43 Yrs Matches City Avg
City Avg: 43.0 Yrs
State Avg: 33.9 Yrs
Regional Practice Density
11 Specialists

Practicing in Topeka, KS (256 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
31.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Peterson (43 Years) 43 Yrs
Topeka Specialty Average (43.0 Years) 43.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
26 15 $99.00 $79.66
99202 New patient office or other outpatient visit, typically 20 minutes
13 13 $109.00 $63.48

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License KS 0422259

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
100144860B (KS)
Commercial Insurance / Payer ID Railroad Medicare
240007246 (KS)
Commercial Insurance / Payer ID Blue Cross
100516 (KS)
Commercial Insurance / Payer ID First Guard
628770 (KS)
Commercial Insurance / Payer ID Tax Id
481191346 (KS)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Sarah Davis

Nurse Practitioner - Family

NPI 1336630102
Dr. Wade Welch , MD

Psychiatry & Neurology - Neurology

NPI 1518962851

Doctor of Medicine (M.D.)

Katie Wohlgemuth , APRN

Nurse Practitioner

NPI 1548920820

Advanced Practice Registered Nurse

NPI 1598143786

Pharmacist

Dr. Camille Heeb , MD

Pediatrics - Adolescent Medicine

NPI 1598728883

Doctor of Medicine (M.D.)

NPI 1710953518

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active April 24, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location April 24, 2012

Registered at 631 SW HORNE ST, STE 400, TOPEKA, KS 666061661 (Tel: 7852349000)

📍
Updated Business Mailing Address April 24, 2012

Registered at 631 SW HORNE ST, STE 400, TOPEKA, KS 666061661 (Tel: 7852349000)

👤
Provider Name / Credentials Updated April 24, 2012

Recorded as JACK PETERSON, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 24, 2012

Specialist (License #0422259 in KS)

🟢
Initial NPI Registration & Enumeration June 09, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508860487
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2005
Last Update: April 24, 2012
Sole Proprietor: Yes

Mailing Address

631 Sw Horne St, Ste 400

Topeka, KS 666061661

Phone: 7852349000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.