Shane L. Petersen, MD
NPI 1770593246ActiveIndividual· Anesthesiology· Murray, UT
Anesthesiology (MD) in Murray, Utah, trained at University of Utah School of Medicine (class of 2001). Medicare paid $15,739 for services to 75 patients in 2024. Octapharma USA, Inc. reported $23.24 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1770593246 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Aug 8, 2006 |
| Last updated in NPPES | Dec 29, 2025 |
| Certified by provider | Dec 29, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology Primary | 207L00000X | 2434068-1205 | UT |
| Anesthesiology | 207L00000X | MD227949 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Anesthesiology (OR); Practitioner - Anesthesiology (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 75 |
|---|---|
| Services billed | 93 across 42 procedure codes |
| Paid by Medicare | $15,739 |
Education and affiliations
| Medical school | University of Utah School of Medicine |
|---|---|
| Graduation year | 2001 |
| Medicare specialty | Anesthesiology |
Medical groups
- Cep America - Anesthesia PCRedding, CA · 849 clinicians
- Mountain West Anesthesia LLCProvo, UT · 271 clinicians
Hospital affiliations
- Intermountain Medical CenterMurray, UT
- Mercy Medical CenterRoseburg, OR
Industry payments (Open Payments)
- 2025$23.24 · 1 payment from 1 company
- 2024$26.08 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Octapharma USA, Inc. | $23.24 | 1 |
What the 2025 payments were for
- Food and Beverage$23.24 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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