CHRISTINE L PETERSEN (NPI# 1578554044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578554044 |
| Entity Type | Individual |
| Full Name | CHRISTINE L PETERSEN |
| Credential | MD |
| Practice Address |
135 Gold Star Blvd Worcester MA 01606-2738 |
| Mailing Address |
630 Plantation St Wot 12th Fl Worcester MA 01605-2038 |
| Practice Telephone | 5088532716 |
| Practice Fax Number | 5088540479 |
| Mailing Telephone | 5088520600 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2012-10-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
220273 | MA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
11735 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MASSMEDICAID | 2061350 | 01 | |
| RIHPILGRIM | AA30992 | 01 | |
| AETNA | CP53876 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831258 | Christine Marie Petersen | Counselor | 601 136th St E, Tacoma, WA 98445-1563 | 2020-04-28 |
| 1295398139 | Christine Margaret Petersen | Student in an Organized Health Care Education/Training Program | 100 Spader Way, Broomfield, CO 80020-2441 | 2019-04-16 |
| 1639580194 | Christine Ann Petersen | Ophthalmology | 908 Jefferson St, Seattle, WA 98104-2433 | 2014-05-17 |
| 1033217385 | Christine V. Petersen | Psychologist | 2530 Crawford Ave, Suite 212, Evanston, IL 60201-4970 | 2006-09-20 |
| Street Address |
135 GOLD STAR BLVD |
| City | WORCESTER |
| State | MA |
| Zip Code | 01606-2738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659875169 | Melissa V. Kusy | Physical Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2018-03-20 |
| 1649710518 | Jennifer A. Foley | Occupational Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2017-02-27 |
| 1033567094 | Briannah M. Mosher | Physical Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2016-06-01 |
| 1174863633 | Krista Abasciano | Developmental Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2013-02-20 |
| 1497083976 | Joanna M Donato | Physical Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2009-11-23 |
| 1114166147 | Randi Lynn Stewart | Speech-Language Pathologist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2009-02-15 |
| 1871730150 | David Pace | Radiology | 135 Gold Star Blvd, Department of Radiology, Worcester, MA 01606-2738 | 2009-01-08 |
| 1467697490 | Jesse J. Little | Physical Therapist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2008-12-04 |
| 1063673028 | Kathryn W Deliso | Optometrist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2008-06-23 |
| 1891982609 | Karen M Comeau | Speech-Language Pathologist | 135 Gold Star Blvd, Worcester, MA 01606-2738 | 2007-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548742612 | Aishea Irine Henry | Counselor | 29 E. Mountian St., Worccester, MA 01606 | 2018-09-05 |
| 1932689874 | Donna Kesler Pearce | Social Worker | Department of Children and Families, 151 West Boylston Drive, Worcester, MA 01606 | 2018-08-20 |
| 1689169914 | Ashley Kalel | Social Worker | 151 W Boylston Dr, Worcester, MA 01606 | 2018-06-28 |
| 1588189039 | Michael Joseph Peters Sr. | Counselor | 56 Malden St, Worcester, MA 01606 | 2017-08-06 |
| 1811418528 | Shan Rai | Social Worker | 29 East Mountain Street, Worcester, MA 01606 | 2017-07-03 |
| 1639608045 | Kim Marie Ceccarini | Case Manager/Care Coordinator | 11 Delaval Rd, Worcester, MA 01606 | 2017-06-08 |
| 1669806139 | Lauren Giuliano | Counselor | 392 Burncoat St, Worcester, MA 01606 | 2013-09-02 |
| 1508132911 | Joshua D Zierler-broudo | Social Worker | 29 East Mountain St, Worcester, MA 01606 | 2012-03-29 |
| 1609096098 | Alternatives Unlimited Inc | Day Training, Developmentally Disabled Services | 367 Burncoat Street, Worcester, MA 01606 | 2007-04-26 |
| 1407908213 | Class One Orthodontic Asso LLC | Dentist | 365 Burncoat St, Worcester, MA 01606 | 2007-01-18 |
| Find all providers in zip 01606 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043508617 | Kathryn R Wagner | Radiology | 10 Belvidere Ave, Worcester, MA 01605 | 2011-07-18 |
| 1922164755 | Brian T Brochu | Radiology | U-mass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655 | 2006-12-28 |
| 1932291184 | Nicholas Constantine Mazanitis | Radiology | 20 Westwood Drive, Worcester, MA 01609 | 2006-09-28 |
| 1053359935 | David M Rogovitz | Radiology | 55 Lake Av North, Umass Memorial Medical Center, Worcester, MA 01655 | 2006-06-03 |
| 1407894777 | David A Phillips | Radiology | 55 Lake Ave North, Umass Memorial/radiology, Worcester, MA 01655 | 2006-06-02 |
| 1134175441 | Abigail M Childs | Radiology | 100 Grove St, Worcester, MA 01605-2627 | 2006-05-26 |
| 1790743177 | Patricia H Sutman | Radiology | 55 Lake Ave N., Umass Memorial, Worcester, MA 01605 | 2006-05-03 |
| 1477520930 | Jorge M Medina | Radiology | 55 Lake Ave N # S2-824, Worcester, MA 01655-0002 | 2006-03-03 |
| 1689197196 | Nazanin Hajarol Asvadi | Radiology | 123 Summer St, Worcester, MA 01608 | 2017-07-18 |
| 1417305632 | Vivek Pargaonkar | Radiology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2016-05-27 |
| Find all providers in WORCESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.