Meritt Aleena Peterson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA196473 Issued in OR

Practice address

2222 NW Lovejoy St Ste 622
Portland, OR 97210-5104

Phone

(503) 229-8455

Fax

(503) 299-7028

NPI assigned

Dec 4, 2019

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 2

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gerald B Rich MD PCGroup PAC ID 0143378471, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85 of 100Reported as group

Quality

75.24

Promoting interoperability

100

Improvement activities

40

Cost

74.75

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpeterson456662@direct.lhs.org

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.

• Gerald B Rich, MD, PC

  • Sleep Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1083855175
  Medicare reassignment Care Compare group
• Gerald B Rich MD PC

  • Sleep Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1043693864
  NPD

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1689211013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 NE 19TH AVE STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322686",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 622",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-229-8455",
            "fax_number": "503-299-7028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 N Graham St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972272003",
            "country_code": "US",
            "telephone_number": "503-229-8455",
            "fax_number": "503-229-7028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MERITT",
        "middle_name": "ALEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA196473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2149182",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500775809",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Peterson, CNM
• Lindsey Louise Peterson, PA-C
• Lucy Rose Peterson, CADC II, QMHA-R
• Matthew Peterson
• Megan Peterson
• Michael Peterson, PA-C
• Michelle Ann Peterson, CADAC-II
• Miguel Peterson
• Nancy Flores Peterson
• Nathan Isaiah Peterson, L.M.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.