Jamie Brooke Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1236 Issued in ID

Practice address

10394 W Henrys Lake Dr
Boise, ID 83709-6283

Phone

(208) 440-0255

Fax

(208) 231-3371

NPI assigned

Feb 4, 2014

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 OR

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Onepeak Southern Oregon PCGroup PAC ID 5395129670, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jamie.petersonpac.p1@direct.opm.nextgenshare.com

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.

• Onepeak Southern Oregon PC

  • Family Medicine Physician
  • Medford, OR
  • NPI 1740917558
  Medicare reassignment Care Compare group
• Nisha Jackson PC

  • Nurse Practitioner
  • Medford, OR
  • NPI 1124499124

  Single Specialty

  NPD

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

• Saint Alphonsus Regional Medical Center Inc

  dba Saint Alphonsus RMC TVL

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1184155426
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  dba St Alphonsus Rehabilitation Services

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1457414948
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298

  Hospital

  Care Compare affiliation
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  Care Compare affiliation

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1487078911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 NE 7TH ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261358",
            "telephone_number": "541-460-5331",
            "fax_number": "541-460-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10394 W HENRYS LAKE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096283",
            "telephone_number": "208-440-0255",
            "fax_number": "208-231-3371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 NE 7th St",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975261358",
            "country_code": "US",
            "telephone_number": "541-460-5331",
            "fax_number": "541-460-5165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JAMIE",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Albert Peterson, M.D.
• Anna Jeannette Peterson, DO
• Christian Peterson, MD
• Conner Peterson, PHARMD
• Forrest Read Peterson
• Janelle Elise Peterson, LCSW
• Jennifer Elaine Peterson, LPC
• John Gregory Peterson, DMD
• Kalika Michelle Peterson
• Katelyn Peterson

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.