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

Nathan Jeffrey Petersen, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1245525930

Nathan Jeffrey Petersen, MD is an Obstetrics/Gynecology in Glendale, Arizona. Graduated from University of Virginia School of Medicine in 2011, 15 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
15
Trained at
University of Virginia School of Medicine
Licensed in
AZ
In the registry since
2011
Specialties on file
2
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

6370 W Union Hills Dr
Glendale, AZ 85308-7136
Phone: (623) 414-3500
Fax: (623) 455-9214
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 51043 (AZ)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence R72843 (AZ)

Record details

NPI number1245525930
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 10, 2011
Last updated in NPPESNovember 2, 2017
Mailing address6370 W Union Hills Dr, Glendale, AZ 85308-7136

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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