James Mathew Petersen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA60710620 Issued in WA

Practice address

12 S 8TH St
Yakima, WA 98901-3020

Phone

(509) 454-4143

NPI assigned

May 8, 2018

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Male

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 WA

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment Care Compare group
• Pinnacle Pain Center, PS

  dba Lynx Healthcare

  • Pain Medicine (Anesthesiology) Physician
  • Kennewick, WA
  • NPI 1740434356
  Medicare reassignment
• Yakima Neighborhood Health Services

  dba Neighborhood Health Terrace Heights

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1750985727
  Medicare reassignment
• Yakima Neighborhood Health Services

  dba Neighborhood Connections Annex

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1285456772
  NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1972869063
  NPD
• Yakima Valley Memorial Physicians

  • Orthopaedic Surgery Physician
  • Yakima, WA
  • NPI 1154015592
  NPD
• Yakima Valley Memorial Physicians

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
  • NPI 1366325870
  NPD
• E & H Holdings, LLC

  dba New Start Clinics

  • Addiction Medicine (Family Medicine) Physician
  • Moses Lake, WA
  • NPI 1962928200
  NPD (past)
• Iroc PS

  dba Latimer Integrative Chiropractic & Rehab

  • Sports Physician Chiropractor
  • Wenatchee, WA
  • NPI 1235256918
  NPD (past)
• Pinnicale Pain Center

  • Medical Physician Assistant
  • Kennewick, WA
  • NPI 1184171290
  NPD (past)

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

• Yakima Valley Memorial Hospital Association

  dba MultiCare Yakima Memorial Hospital

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480
  Care Compare affiliation

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1275022964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JAMES",
        "middle_name": "MATHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60710620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Perry
• Shannon Maureen Perry
• Pete K Nathe DDS PC
• Angela Patricia Peters
• Erik E Petersen
• Krysta Peterson- Niece, CDPT
• Alisa L Peterson, LICSW
• Ashley Peterson, CM60876442
• Blake T Peterson, CRNA
• Carl V Peterson, MD

• Medical Physician Assistant in Yakima, WA
• Providers in Yakima, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.