Individual provider Active NPI

Heather Marie Peterson, PA-C

  • Physician Assistant
  • Holyoke, MA
National Provider Identifier
1821419862
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4904 Issued in MA
Practice address
1233 Main St
Holyoke, MA 01040-5381
Phone
(413) 264-0849
Fax
(413) 319-3044
NPI assigned
Dec 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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 4904 MA Primary

Addresses

Primary practice location

1233 Main St
Holyoke, MA 01040-5381

Mailing address

1233 Main St
Holyoke, MA 01040-5381
Phone (413) 264-0849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140924000031 MA Practitioner - Physician Assistant 5294954228 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holyoke Capital JV, LLCGroup PAC ID 7517373079, 31 clinicians

Practice addresses (Care Compare)

1233 Main St
Holyoke, MA 01040-5381
Phone (413) 264-0819

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4904MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holyoke Capital JV, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

1233 Main St
Holyoke, MA 01040
Phone (413) 264-0819

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1821419862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 MAIN ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405381",
            "telephone_number": "413-264-0849",
            "fax_number": "413-319-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 MAIN ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405381",
            "telephone_number": "413-264-0849",
            "fax_number": "413-319-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "4904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.