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Dr. Antonique Peterson , DO

General Practice • Minneapolis, MN

Active NPI 1700377124 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

1313 Penn Ave N
Minneapolis, MN 554113047

Call 6125432500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1313 Penn Ave N

Minneapolis, MN 554113047

Telephone 6125432500
Organization at the Same NPPES Address or Phone
Pillsbury United Communities Facility NPI 1912064312

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Emory Physicians Group, Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Medical School

Arizona College Of Osteopathic Medicine Mid Western University

Graduation Year

2018

30-day fills

36 standardized 30-day fills in 2022

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$299 in 2022

The total cost of these prescriptions in 2022, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2022.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

Years since graduation

8 years (graduated 2018)

CMS Doctors and Clinicians data list 2018 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Peterson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Peterson as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Minneapolis and Minnesota

Billing and prescribing volume is not a quality rating.

Medicare Part D

Comparisons use 2024 data. The latest CMS data for Dr. Peterson are from 2022.

17 active clinicians are listed under General Practice with a practice address in Minneapolis, MN (79 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Minneapolis

0% of these 17 clinicians have the CMS telehealth indicator.

17.6% of these 17 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Part D Prescribers (2022), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2022.

CMS Part D · Data Year 2022
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Atorvastatin Calcium Atorvastatin Calcium 20 1,080 $299.29 —

Source: CMS Part D by Provider and Drug, 2022; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-10-27
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

License # reported to NPPES MN 69440

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
416005801 (MN)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - FAMILY PRACTICE

Medicare Enrollment ID

I20260520004031

Enrollment State Jurisdiction

GA

PECOS Control ID

7719375658

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Emory Physicians Group, Llc

1311 Johnson Ferry Rd, Marietta, GA 300682947

Phone: 8886636331

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

24 listed
NPI 1346729308

Doctor of Dental Surgery

Dr. Erin Anderson , MD

Family Medicine

NPI 1790341295

Doctor of Medicine (M.D.)

NPI 1184164337
Dr. Janna Carlson , MD

Family Medicine

NPI 1447217849

Doctor of Medicine (M.D.)

NPI 1982656781

Doctor of Medicine (M.D.)

Dr. Drew Dietle , MD

Family Medicine

NPI 1629431416

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
📍
Updated Practice Location October 27, 2021

Registered at 1313 PENN AVE N, MINNEAPOLIS, MN 554113047 (Tel: 6125432500)

📍
Updated Business Mailing Address October 27, 2021

Registered at 1313 PENN AVE N, MINNEAPOLIS, MN 554113047 (Tel: 6125432582)

✅
NPI Profile Active May 21, 2018

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) May 21, 2018

Registered at 350 W THOMAS RD, PHOENIX, AZ 850134409 (Tel: 6024063153)

📍
Business Mailing Address (Initial Record) May 21, 2018

Registered at 350 W THOMAS RD, PHOENIX, AZ 850134409 (Tel: 6024063153)

👤
Provider Name / Credentials (Initial Record) May 21, 2018

Recorded as ANTONIQUE PETERSON, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 21, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1700377124
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2018
Last Update: October 27, 2021
Sole Proprietor: No

Other General Practices in Minneapolis

All General Practices in Minneapolis

Mailing Address

1313 Penn Ave N

Minneapolis, MN 554113047

Phone: 6125432582

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.