Individual provider Active NPI

Darryl L Peterson, PA-C

  • Physician Assistant
  • Junction City, KS
National Provider Identifier
1760454425
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-01662 Issued in KS
Practice address
1110 Saint Marys Rd
Junction City, KS 66441-4176
Phone
(857) 762-2585
Fax
(785) 210-3438
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-01662 KS Primary

Addresses

Primary practice location

1110 Saint Marys Rd
Junction City, KS 66441-4176

Mailing address

1110 Saint Marys Rd
Junction City, KS 66441-4176
Phone (857) 762-2585

Other identifiers 1

IdentifierTypeStateIssuer
42880500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20230523000895 KS Practitioner - Physician Assistant 8628091956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1102 Saint Marys Rd
Junction City, KS 66441-4139
Phone (785) 762-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.68 of 100Reported as group
Quality
81.78
Promoting interoperability
100
Improvement activities
40
Cost
69.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
850MNMDPodiatrist
15-01662KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stormont Vail Health Flint Hills LLC CurrentSince Apr 22, 2023 Accepting new patients
Stormont Vail Health Flint Hills LLC CurrentSince Apr 22, 2023 Accepting new patients

Locations

1102 Saint Marys Rd
Junction City, KS 66441
Phone (785) 238-0325

1110 Saint Marys Rd
Junction City, KS 66441
Phone (785) 238-4131

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1760454425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SAINT MARYS RD",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414176",
            "telephone_number": "857-762-2585",
            "fax_number": "785-210-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SAINT MARYS RD",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414176",
            "telephone_number": "857-762-2585",
            "fax_number": "785-210-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DARRYL",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42880500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

Verify at the official NPI Registry.