Devin R Petersen, PHD

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

Practice address

3517 NW Samaritan Dr Ste 100
Corvallis, OR 97330-3768

Phone

(541) 768-4280

NPI assigned

Jul 30, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.14 of 100Reported as group

Quality

85.78

Promoting interoperability

100

Improvement activities

40

Cost

78.31

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpetersen191904@samhealth.direct-ci.com

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.

• Good Samaritan Hospital Corvallis

  • General Acute Care Hospital
  • Corvallis, OR
  • NPI 1962453134
  Medicare reassignment Care Compare group NPD
• Good Samaritan Hospital Corvallis

  • Family Medicine Physician
  • Corvallis, OR
  • NPI 1376809475
  NPD
• Good Samaritan Hospital Corvallis

  • Gynecologic Oncology Physician
  • Corvallis, OR
  • NPI 1710787916
  NPD

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1306572441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 NW SAMARITAN DR STE 100",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303768",
            "telephone_number": "541-768-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3517 NW Samaritan Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303769",
            "country_code": "US",
            "telephone_number": "541-768-5142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "DEVIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-30",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpetersen191904@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3517 NW Samaritan Dr Ste 100",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Dawn Peters, MS, CCC-SLP
• Cathryn Peters, RPH
• Emily Grace Peters
• Carly Peterschmidt, DMD
• Pamela Michelle Peterschmidt, PT DPT
• Joyelle Lynn Petersen
• Victoria Leigh Petersen, CACD-R, CRM
• Benjamin David Peterson
• Janet P Peterson, DMD
• Janice Kathleen Peterson, DO

• Health Psychologist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Health Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.