Individual provider Active NPI

Patrick Jay Peters, PA-C

  • Physician Assistant
  • Lincoln, NE
National Provider Identifier
1861704363
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1531 Issued in NE
Practice address
575 S 70TH St
Suite 200
Lincoln, NE 68510-2471
Phone
(402) 488-3322
Fax
(402) 488-1172
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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 1531 NE Primary

Addresses

Primary practice location

575 S 70TH St
Suite 200
Lincoln, NE 68510-2471

Mailing address

575 S 70TH St
Suite 200
Lincoln, NE 68510-2471
Phone (402) 488-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20100819000302 NE Practitioner - Physician Assistant 2365576832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nebraska Orthopaedic Center PCGroup PAC ID 2567432461, 65 clinicians

Practice addresses (Care Compare)

1621 Front St
Henderson, NE 68371-8902
Phone (402) 723-4512

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 475-1011

555 S 70TH St
CHI Health Saint Elizabeth
Lincoln, NE 68510-2462
Phone (402) 219-7700

575 S 70TH St
Lincoln, NE 68510-2471
Phone (402) 436-2000

6900 A St
Lincoln, NE 68510-4120

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.8 of 100Reported as group
Quality
89.76
Promoting interoperability
99
Improvement activities
40
Cost
70.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1531NEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Orthopaedic Center PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

575 S 70th St
Ste 200
Lincoln, NE 68510
Phone (402) 436-2000

6900 A St
Ste 100
Lincoln, NE 68510
Phone (402) 436-2000

Interoperability endpoints

  • Direct secure messaging: patrick.peters.1@32860.direct.athenahealth.com

Organizations & group practices 1

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 7

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1861704363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 S 70TH ST",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102471",
            "telephone_number": "402-488-3322",
            "fax_number": "402-488-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 S 70TH ST",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102471",
            "telephone_number": "402-488-3322",
            "fax_number": "402-488-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "PATRICK",
        "middle_name": "JAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.