Sydney Rae Petersen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3367 Issued in NE

Practice address

4101 Tiger Lily Rd Ste 100
Lincoln, NE 68516-5587

Phone

(402) 420-7000

Fax

(402) 420-6969

NPI assigned

Jul 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: admin@sncc.oncoemrdirect.com

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1093551715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TIGER LILY RD STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165587",
            "telephone_number": "402-420-7000",
            "fax_number": "402-420-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "SYDNEY",
        "middle_name": "RAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@sncc.oncoemrdirect.com",
            "affiliation": "N",
            "address_1": "4101 Tiger Lily Rd Ste 100",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685165587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Megan Petersen, PHARMD
• Michelle A Petersen, PA-C
• Michelle B Petersen, M.D.
• Paul F Petersen, MD
• Sharee Petersen
• Peterson Chiropractic Inc
• Ann Peterson
• Ashley Peterson
• Brianne Peterson, OTD, OTR/L
• Brooke Peterson

• Physician Assistant in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.