JOHN J PETERSEN PA
NPI 1164580429
Physician Assistant - Surgical in Medford, OR

NPI Status: Active since December 05, 2006

Contact Information

520 MEDICAL CENTER DR
SUITE 201
MEDFORD, OR
ZIP 97504
Phone: (541) 789-5710

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  • Individual
  • Male
  • Physician Assistant
  • Surgical

About JOHN PETERSEN

This page provides the complete NPI Profile along with additional information for John Petersen, a provider established in Medford, Oregon with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1164580429 assigned on December 2006. The practitioner's primary taxonomy code is 363AS0400X with license number PA00228 (OR). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1164580429
Provider Name
JOHN J PETERSEN PA
Gender
Male
Entity Type
Individual
Location Address
520 MEDICAL CENTER DR SUITE 201 MEDFORD, OR 97504
Location Phone
(541) 789-5710
Mailing Address
2620 E BARNETT RD SUITE H MEDFORD, OR 97504
Mailing Phone
(541) 789-5250
Is Sole Proprietor?
No
Enumeration Date
12-05-2006
Last Update Date
01-16-2013
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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

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA00228
License State
OR

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
R164473MEDICARE PIN (08)OR 
500613512MEDICAID (05)OR 

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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 1164580429, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
2
Doubled → 4
Check
9
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 6 → 12 → 3 5 → 10 → 1 0 → 0 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 1 + 0 + 8 + 0 + 4 + 4 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1164580429.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Internal Medicine (Clinical Cardiac Electrophysiology)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 100
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 100
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 100
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Physician Assistant
520 MEDICAL CENTER DR, SUITE 300
MEDFORD, OR 97504
Physician Assistant (Surgical)
520 MEDICAL CENTER DR, SUITE 300
MEDFORD, OR 97504
Thoracic Surgery (Cardiothoracic Vascular Surgery)
520 MEDICAL CENTER DR, SUITE 201
MEDFORD, OR 97504
Thoracic Surgery (Cardiothoracic Vascular Surgery)
520 MEDICAL CENTER DR, SUIT 201
MEDFORD, OR 97504
Thoracic Surgery (Cardiothoracic Vascular Surgery)
520 MEDICAL CENTER DR, SUITE 201
MEDFORD, OR 97504
Thoracic Surgery (Cardiothoracic Vascular Surgery)
520 MEDICAL CENTER DR, SUITE 201
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Internal Medicine (Cardiovascular Disease)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Internal Medicine (Interventional Cardiology)
520 MEDICAL CENTER DR, STE 200
MEDFORD, OR 97504
Internal Medicine (Interventional Cardiology)
520 MEDICAL CENTER DR, SUITE 200
MEDFORD, OR 97504
Physician Assistant (Medical)
520 MEDICAL CENTER DR, STE 300
MEDFORD, OR 97504

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164580429, enumerated as an "individual" on December 05, 2006.

The provider is located at 520 MEDICAL CENTER DR SUITE 201 MEDFORD, OR 97504 and the phone number is (541) 789-5710.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.