Evan Douglas Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

088343 Issued in IA

Practice address

6520 SE 14TH St
Des Moines, IA 50320-1846

Phone

(515) 953-1500

Fax

(515) 953-2136

NPI assigned

Aug 1, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint at Home Home health agency, Urbandale, IA, CCN 167148
• Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: epeterson556576@direct.unitypoint.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Iowa Physicians Clinic Medical Foundation

  • Rural Health Clinic/Center
  • Correctionville, IA
  • NPI 1639061583

  Family Medicine

  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Unitypoint at Home

  • Home Health Agency
  • West Des Moines, IA
  • NPI 1194753863
  Care Compare affiliation Name & address match
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1356433049
  Care Compare affiliation
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1396837951
  Care Compare affiliation
• Central Iowa Hospital Corporation

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1598905762
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1003330036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SW 3RD ST APT 403",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503094832",
            "telephone_number": "515-577-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 SE 14TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503201846",
            "telephone_number": "515-953-1500",
            "fax_number": "515-953-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EVAN",
        "middle_name": "DOUGLAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "088343",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "088343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Rae Petersen, NURSE PRACTITIONER
• Peterson Family Dental, PC
• Alicia Peterson, RN
• Cynthia W Peterson, NP
• Eric M Peterson, PHARM.D.
• Gregory E Peterson, D.O.
• Hannah Peterson, DO
• Harold Lars Peterson, LMSW
• I Eugene Peterson, M.D.
• Jason R Peterson, R D

• Physician Assistant in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.