Lindsey Peterson, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA217726 Issued in OR

Practice address

2546 NE Conners Ave Ste 210
Bend, OR 97701-6761

Phone

(541) 508-4858

NPI assigned

Sep 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lindsey Ackles Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Omhc, LLC

  • Clinic/Center
  • Bend, OR
  • NPI 1356848352
  NPD (past)
• Now Health, LLC

  • Primary Care Clinic/Center
  • Palmer, AK
  • NPI 1467874933
  NPD (past)

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1912215005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 NE CONNERS AVE STE 210",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016761",
            "telephone_number": "541-508-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 NE CONNERS AVE STE 210",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016761",
            "telephone_number": "541-508-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LINDSEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PA217726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "ACKLES",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peterson Performance Products Inc
• Peterson Performance Products, Inc.
• Jake Allen Peterson, DDS, MD
• Jodi Peterson
• Johanna Rae Peterson, PA-C
• Sarah Elizabeth Peterson, LCSW
• Theresa Ann Peterson
• Carol J Petherbridge, ND
• Nickolas Petragallo, CRM/PSS
• Jacqueline Petrovic

• Family Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.