BENJAMIN DAVID PETERSON
NPI 1083987903
Counselor - Mental Health in Corvallis, OR
NPI Status: Active since February 23, 2012
Contact Information
4455 NE HW 20
CHILDREN'S FARM HOME
CORVALLIS, OR
ZIP 97330
Phone: (541) 758-5900
- Individual
- Male
- Counselor
- Mental Health
- Accepts Insurance
- Opted-Out Medicare
About BENJAMIN PETERSON
This page provides the complete NPI Profile along with additional information for Benjamin Peterson, a provider established in Corvallis, Oregon with a medical specialization in Counselor, focusing in mental health . The healthcare provider is registered in the NPI registry with number 1083987903 assigned on February 2012. The practitioner's primary taxonomy code is 101YM0800X. The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1083987903
- Provider Name
- BENJAMIN DAVID PETERSON
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4455 NE HW 20 CHILDREN'S FARM HOME CORVALLIS, OR 97330
- Location Phone
- (541) 758-5900
- Mailing Address
- 3415 SE POWELL BLVD PORTLAND, OR 97202
- Mailing Phone
- (503) 234-9591
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-23-2012
- Last Update Date
- 07-19-2017
- Code Navigator
A mental health counselor like Benjamin Peterson provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Benjamin Peterson opted out of Medicare effective on 09-17-2025 until 09-17-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-17-2025
Opt-Out End Date: 09-17-2027
Eligible to Order and Refer? No
Reviews for BENJAMIN DAVID PETERSON
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1083987903, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083987903, enumerated as an "individual" on February 23, 2012.
The provider is located at 4455 NE HW 20 CHILDREN'S FARM HOME CORVALLIS, OR 97330 and the phone number is (541) 758-5900.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.. Please consult your insurance carrier or call the provider to verify.
