Michael G Petersen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06055 Issued in TX

Practice address

7201 Manchaca Rd
Ste B
Austin, TX 78745-5283

Phone

(512) 443-3577

Fax

(512) 445-6027

NPI assigned

Apr 7, 2009

Last updated

Mar 18, 2011By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Texas Southwestern Medical School at Dallas, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adult Care of Austin PAGroup PAC ID 3173519972, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robinson Creek Home Health and Hospice Home health agency, Austin, TX, CCN 677433

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Adult Care of Austin PA

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1619982147
  Medicare reassignment Care Compare group

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

• Lagniappe Health Care Investments, LLC

  dba Robinson Creek Home Health and Hospice

  • Home Health Agency
  • Austin, TX
  • NPI 1013008325
  Care Compare affiliation

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1972746931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 MANCHACA RD",
            "address_2": "STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455283",
            "telephone_number": "512-443-3577",
            "fax_number": "512-445-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 MANCHACA RD",
            "address_2": "STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455283",
            "telephone_number": "512-443-3577",
            "fax_number": "512-445-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Ann Peters, CRNA
• Bethany Anne Petersen, DDS
• Christie Petersen, M.ED., LBA
• Megan Petersen, PT, DPT
• Michael Charles Petersen, M.D.
• Rosann Petersen, RDN
• Ashley Paige Jordan Peterson Sconzo, AU.D.
• Arthur Darwin Peterson, D.C.
• Betty Peterson, PHD
• Camila Rose Peterson

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; 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.