Skye J Peltier, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA170083 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Mail Code CDRC
Portland, OR 97239-3011

Phone

(503) 494-8716

Fax

(503) 494-2721

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Skye J Johnson Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

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.

• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  • Hospitalist Physician
  • Edina, MN
  • NPI 1770663031
  NPD
• Oregon Health & Science University

  • Clinic/Center
  • Portland, OR
  • NPI 1972688919
  NPD (past)
• Childrens Health Care

  dba Childrens Hospitals and Clinics of Minnesota

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1629161781
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1346218443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8716",
            "fax_number": "503-494-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAIL CODE CDRC",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-8716",
            "fax_number": "503-494-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "SKYE",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9999",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA170083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448159300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SKYE",
            "last_name": "JOHNSON",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol Pelmas, MD
• Nicole Marie Peloquin
• Catherine F Pelosi, CNM
• Lisbeth Pelsue, RN
• Antonietta Rose Pelsuo
• Monte C Pelto, CADCII
• Grace Pelton
• Joseph Max Pelz, DMD
• Kyzen Pemberton, LMT
• Tara Pemberton, PA-C

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.