Active NPI
Jesse Robert Peterson, DPT
- Clinical Electrophysiology Physical Therapist
- San Antonio, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Electrophysiology Physical Therapist
- License
- 1408526
- Practice address
- 3327 Research PLZ Ste 215
San Antonio, TX 78235-5157 - Phone
- (210) 804-5400
- NPI assigned
- Feb 17, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Electrophysiology Physical Therapist | 2251E1300X | 1408526 | TX | Primary |
Addresses
Primary practice location
3327 Research PLZ Ste 215
San Antonio, TX 78235-5157
Mailing address
400 Concord Plaza Dr Ste 300
San Antonio, TX 78216-6991
Phone (210) 804-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8727 W Ardene St
Suite 102G
Boise, ID 83709-2627
Phone (208) 322-6200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonald Rehab, PC | Physical Therapist | Current | Accepting new patients |
| Mountain Land Rehabilitation LLC | Physical Therapist | Current | Accepting new patients |
Locations
1435 S Maple Grove Rd
Boise, ID 83709
Phone (208) 322-6200
1961 S Broadway Ave
Boise, ID 83706
Phone (208) 344-1851
8727 W Ardene St
Ste 102G
Boise, ID 83709
Phone (208) 322-6200
4623 Enterprise Way
Caldwell, ID 83605
Phone (208) 455-4231
912 S Washington Ave
Emmett, ID 83617
Phone (208) 365-4400
2210 Coronado St
Idaho Falls, ID 83404
Phone (208) 317-3956
1680 E 1st St
Idaho Falls, ID 83401
Phone (208) 417-0090
3345 Potomac Way
Idaho Falls, ID 83404
Phone (208) 417-0090
672 E Wythe Creek Ct
Ste 103
Kuna, ID 83634
Phone (208) 922-9828
1450 E Fairview Ave
#201
Meridian, ID 83642
Phone (208) 887-6757
5251 E Exchange Way
Nampa, ID 83687
Phone (208) 466-9642
1800 Flandro Dr
Ste 190
Pocatello, ID 83202
Phone (208) 233-2248
128 Vista Dr
Pocatello, ID 83201
Phone (208) 233-2248
370 N Haven Dr
Ste 102
Twin Falls, ID 83301
Phone (208) 398-3776
Organizations & group practices 2
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.
-
- Physical Therapist
- Pocatello, ID
- NPI 1497948509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785110400000",
"number": "1104571256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CONCORD PLAZA DR STE 300",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782166991",
"telephone_number": "210-804-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3327 RESEARCH PLZ STE 215",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782355157",
"telephone_number": "210-804-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JESSE",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-17",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "2251E1300X",
"taxonomy_group": "",
"desc": "Physical Therapist, Electrophysiology, Clinical",
"state": "TX",
"license": "1408526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.