SHANE L PETERSEN MD NPI 1770593246

NPI Information

  • NPI: 1770593246
  • Provider Name: SHANE L PETERSEN, MD
  • Classification: Anesthesiology - 207L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5121 S COTTONWOOD STREET
    INTERMOUNTAIN MEDICAL CENTER
    MURRAY, UT
    ZIP 84157
  • Phone: (801) 507-5248

Map and Directions

Get Directions

NPI Details

Shane L Petersen, MD is an anesthesiology in Murray, UT with 24 years of experience. The provider is an anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. Shane L Petersen, MD NPI is 1770593246. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:2001

The provider's business location address is:

5121 S COTTONWOOD STREET
INTERMOUNTAIN MEDICAL CENTER
MURRAY, UT
ZIP 84157
Phone: (801) 507-5248
Fax: (801) 733-5618

The NPI 1770593246 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasonic guidance for needle placement (HCPCS:76942)
  • Anesthesia for extensive surgery on spine (HCPCS:00670)

The enumeration date for this NPI number is 8/8/2006 and was last updated on 10/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiology2434068-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1107038030101OTHERUTAHIHC
224340681200001OTHERUTAHREGENCE BCBS
3QM0000075886OTHERUTAHALTIUS
4100506343MEDICAIDNEVADA
5807171600MEDICAIDIDAHO
6941379MEDICAIDARIZONA
7055327146MEDICARE ID-TYPE UNSPECIFIEDUTAH
883770OTHERUTAHPEHP
9907869OTHERUTAHDESERET MUTUAL
1099469OTHERUTAHHEALTHY U
11121124200MEDICAIDWYOMING
121502954OTHERUTAHUMWA
132090168OTHERUTAHUNITED HEALTHCARE
14QMP000003262280OTHERUTAHMOLINA
15I39965MEDICARE UPINUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.