RONALD D PETERSEN — NPI 1881900967 (Licensed & Credentialed Counselor, Pastoral in LIMERICK, ME)

CMS-1500 Box 24J / 33a • NPI

1881900967

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

101YP1600X

Licensed & Credentialed Counselor, Pastoral

Box 32 Service Location & ZIP+4

143 WASHINGTON ST, LIMERICK, ME, 04048-3502

✓ 9-Digit EDI 837 ZIP+4 (04048-3502)

Practice Phone & Referral Fax

(207) 793-8444

Direct NPPES Verification Line

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1881900967 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(1) — Conviction of Program-Related Crimes (Mandatory 5-Yr Min) — Effective 2015-09-20). Verify before submitting Medicare/Medicaid claims.

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1881900967` (NPI-1 Individual Practitioner)
Provider / Legal Name	RONALD D PETERSEN
Plain-English Specialty	Licensed & Credentialed Counselor, Pastoral NUCC Code: `101YP1600X` (Counselor, Pastoral)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	143 WASHINGTON ST, LIMERICK, ME, 04048-3502
Practice Telephone / Fax	Tel: (207) 793-8444
Administrative Mailing Address	147 WASHINGTON ST, LIMERICK, ME, 04048-3502
Enumeration & Last Sync	Enumerated: 2010-08-26 \| CMS Record Updated: 2010-08-26

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

143 WASHINGTON ST, LIMERICK, ME, 04048-3502

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Plain-English Taxonomy & CMS Crosswalk (101YP1600X)

What Does Taxonomy Code 101YP1600X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YP1600X translates to:
"Licensed & Credentialed Counselor, Pastoral"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor, Pastoral for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (RONALD D PETERSEN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YP1600X` — Counselor, Pastoral Plain English: Licensed & Credentialed Counselor, Pastoral	State: ME \| License: `606510` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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RONALD D PETERSEN (NPI #1881900967)