Jeffrey Petersen, PT MOMT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1295 Issued in AZ

Practice address

1844 E Baseline Rd Ste C5
Tempe, AZ 85283-1506

Phone

(480) 833-1005

Fax

(480) 833-1312

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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 AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of New England, College of Osteo Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Petersen Physical Therapy PCGroup PAC ID 5991794117, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

19.23 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

64.11

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICIFBD

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.

• Petersen Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Tempe, AZ
  • NPI 1578673562
  Medicare reassignment Care Compare group NPD
• Carling Physical Therapy

  • Physical Therapist
  • Gilbert, AZ
  • NPI 1396882999
  NPD (past)
• Sonoran Spine Center P.C.

  • Orthopaedic Surgery of the Spine Physician
  • Tempe, AZ
  • NPI 1013975333
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1841389699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E BASELINE RD STE C5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831506",
            "telephone_number": "480-833-1005",
            "fax_number": "480-833-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 E BASELINE RD STE C5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831506",
            "telephone_number": "480-833-1005",
            "fax_number": "480-833-1312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21300 N John Wayne Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Maricopa",
            "state": "AZ",
            "postal_code": "851398978",
            "country_code": "US",
            "telephone_number": "520-568-2723",
            "fax_number": "520-568-2865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "PT MOMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "1295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darcie Peterman
• James J Peterman Jr., M.D.
• Carrie M Peters, LPC
• Rima H Peters, D.M.D.
• Petersen Physical Therapy PC
• Joshua Ryan Peterson, ARNP
• Kathleen E Peterson, DOCTOR OF AUDIOLOGY
• Leslie Peterson, LPC
• Robin Peterson
• Michael M Petkovic, OT

• Physical Therapist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.