Henry Petersen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-1146 Issued in ID

Practice address

700 W Ironwood Dr
Ste 320
Coeur D Alene, ID 83814-2656

Phone

(208) 625-5250

Fax

(208) 625-5251

NPI assigned

Oct 16, 2013

Last updated

Jul 22, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as apm

Quality

89.26

Promoting interoperability

69.9

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hpetersen610745@direct.multicare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur d'Alene, ID
  • NPI 1174661151
  Medicare reassignment Care Compare group
• Kootenai Health, Inc.

  dba Kootenai Medical Center Group

  • Emergency Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1235288655
  Medicare reassignment NPD (past)
• Kootenai Health, Inc.

  dba Kootenai Health Pharmacy

  • Community/Retail Pharmacy
  • Hayden, ID
  • NPI 1235986290
  NPD
• Kootenai Health, Inc.

  • Rehabilitation Hospital Unit
  • Coeur d'Alene, ID
  • NPI 1659476455
  NPD
• Incyte Pathology, LLC

  dba InCyte Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Spokane Valley, WA
  • NPI 1326086745
  NPD

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1891123543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5085",
            "fax_number": "208-625-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "STE 320",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656",
            "telephone_number": "208-625-5250",
            "fax_number": "208-625-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hpetersen610745@direct.multicare.org",
            "affiliation": "N",
            "address_1": "700 W Ironwood Dr",
            "address_2": "Ste 320",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838142656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia Bragg Pesco, PT
• Kurt Alexander Petellin, DDS
• Peter C Jones MD PA
• Kevin Patrick Peters, PA-C
• Emily Lara Petersen, MD
• Lori Petersen
• Mariah Petersen, APP
• Chad Allan Peterson, M.D.
• Heather Peterson
• Hunter Peterson, N.D.

• Medical Physician Assistant in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.