Johnathan L. Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05099 Issued in TX

Practice address

204 E Fair Oaks PL
San Antonio, TX 78209-3811

Phone

(210) 315-4601

NPI assigned

Nov 28, 2006

Last updated

Feb 6, 2025By 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 TX

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The San Antonio Orthopaedic Group LLPGroup PAC ID 6800798794, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnathan.peterson.1@94.direct.athenahealth.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.

• The San Antonio Orthopaedic Group, LLP

  • Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1720022494
  Medicare reassignment Care Compare group
• Elevated Medical Services

  • Physician Assistant
  • Alamo Heights, TX
  • NPI 1740094887
  Authorized official Same address or phone
• The San Antonio Orthopaedic Group, LLP

  • Orthopedic Physical Therapist
  • San Antonio, TX
  • NPI 1770042152
  NPD
• Sports Medicine Associates of San Antonio, PA

  dba Center for Physical Therapy & Sports Performance

  • Physical Therapist
  • San Antonio, TX
  • NPI 1609124312
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1568538742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E FAIR OAKS PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093811",
            "telephone_number": "210-315-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E FAIR OAKS PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782093811",
            "telephone_number": "210-315-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOHNATHAN",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Nicole Peterson
• Jesse Robert Peterson, DPT
• Jessica M Peterson, OTR, MOT
• Jodi Peterson, OTR/L
• Jodi Gale Peterson
• Joshua Michael Peterson, M.D.
• Lanny C. Peterson, CTRS
• Lauren Ashley Peterson, MD
• Lauren Michelle Peterson, DDS
• Le-My Linh Peterson, RN

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.