Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Dustin J Petersen, MD

Individual provider Surgery Physician · NPI 1265661383

Dr. Dustin J Petersen, MD is a General Practice in Fort Wayne, Indiana. Qualified in 2007, 19 years ago. Practices with Visiting Nurse and Hospice Home Inc, a 6-clinician group and accepts Medicare assignment. Licensed in Indiana and West Virginia.

Years since qualifying
19
Licensed in
IN, WV
In the registry since
2009
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845-1715
Phone: (260) 266-8900
Fax: (260) 266-8935
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Critical Care Physician (primary) Taxonomy 2086S0102X · Licence 01073898A (IN)
Surgery Physician Taxonomy 208600000X · Licence 26510 (WV)
Surgery Physician Taxonomy 208600000X · Licence 01073898A (IN)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 26510 (WV)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence 26510 (WV)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence 01073898A (IN)

Record details

NPI number1265661383
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 10, 2009
Last updated in NPPESOctober 10, 2022
Certification dateOctober 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Also practisesHOSPICE/PALLIATIVE CARE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Visiting Nurse And Hospice Home Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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