Individual provider Active NPI

Brigitte Peterson, PA-C

  • Physician Assistant
  • Yerington, NV
National Provider Identifier
1053824722
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1484 Issued in NV
Practice address
171 Campbell LN
Yerington, NV 89447-9768
Phone
(775) 783-0222
Fax
(775) 463-5925
NPI assigned
Nov 15, 2017
Last updated
Nov 15, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1484 NV Primary

Addresses

Primary practice location

171 Campbell LN
Yerington, NV 89447-9768

Mailing address

8096 Anselmo CT
Reno, NV 89523-8992
Phone (775) 343-6249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180207002650 NV Practitioner - Physician Assistant 5294095451 Reassigns benefits to 1 organization
I20240917000191 TX Practitioner - Physician Assistant 5294095451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walker River Paiute TribeGroup PAC ID 9133565203, 3 clinicians

Practice addresses (Care Compare)

PO Box C
Schurz, NV 89427

PO Box C
Schurz, NV 89427-0502

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Walker River Paiute Tribe CurrentSince Jul 1, 2024 Accepting new patients
Walker River Paiute Tribe CurrentSince Jul 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bpeterson@ypt.directbygreenway.com

Organizations & group practices 3

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1053824722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8096 ANSELMO CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895238992",
            "telephone_number": "775-343-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CAMPBELL LN",
            "city": "YERINGTON",
            "state": "NV",
            "postal_code": "894479768",
            "telephone_number": "775-783-0222",
            "fax_number": "775-463-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BRIGITTE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yerington, NV

Sources for this page

Verify at the official NPI Registry.