Mendy Marie Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1874 Issued in NE

Practice address

17030 Lakeside Hills PLZ
Suite 102
Omaha, NE 68130-2396

Phone

(402) 758-5800

Fax

(402) 758-5809

NPI assigned

Jul 13, 2005

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

Medicare fee-for-service enrollment

Enrolled in NE

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care of Nebraska PCGroup PAC ID 0840331096, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• American Current Care of Nebraska PC

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1528245727

  NE

  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD
• American Current Care of Nebraska PC

  • Urgent Care Clinic/Center
  • Omaha, NE
  • NPI 1992982185
  NPD
• Internal Medicine Clinic Inc.

  • Specialist
  • Fort Collins, CO
  • NPI 1881725844
  NPD (past)
• Quantum Plus LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1235188962

  Physician Assistant

  NPD (past)
• Value in Prevention of Colorado PLLC

  • Internal Medicine Physician
  • Fort Collins, CO
  • NPI 1356863245
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1205834173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17030 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302396",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17030 LAKESIDE HILLS PLZ",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302396",
            "telephone_number": "402-758-5800",
            "fax_number": "402-758-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MENDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggie Peterson
• Marcie H Peterson, MD
• Maria Peterson
• Matthew Warren Peterson, FNP
• McKensie Peterson, DPT
• Nancy Ruth Peterson
• Nicole E Peterson, APRN
• Nicolle Lynette Peterson, DO
• Rhonda C Peterson, REGISTERED SCHOOL NU
• Richard Peterson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.