Iris Peter, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-2540 Issued in ID

Practice address

1550 Elk Creek Dr
Idaho Falls, ID 83404-8322

Phone

(208) 529-5942

Fax

(208) 529-5951

NPI assigned

Jan 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, ID2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavitt Womens Healthcare Corp.PCGroup PAC ID 6709809502, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Leavitt Womens Healthcare Corp,P.C.

  • Obstetrics & Gynecology Physician
  • Idaho Falls, ID
  • NPI 1972771756
  Medicare reassignment Care Compare group
• Raincross Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1932615077
  Medicare reassignment

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1669060562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-529-5942",
            "fax_number": "208-529-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048322",
            "telephone_number": "208-529-5942",
            "fax_number": "208-529-5951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 Brockton Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925060104",
            "country_code": "US",
            "telephone_number": "951-774-2942",
            "fax_number": "951-774-2945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETER",
        "first_name": "IRIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-2540",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Care Services LLC
• Personal Growth Corporation
• Eric W. Perttula, M.D.
• Lisa Anne Perucca, LMSW
• Kiley Petencin
• Ryne Shawn Peters, DO
• Betsy Pack Petersen, LMSW
• Emily Petersen
• Peterson Speech Therapy
• Peterson Therapy Services, Inc

• Medical Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.