DR. JED RUSSELL PETERSON M.D.
NPI 1164634770
Radiology - Vascular & Interventional Radiology in Portland, OR

Q: What is Jed Peterson's NPI number?

The NPI number for Jed Peterson is 1164634770. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Q: What is Jed Peterson's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Q: When was this NPI record last updated?

The NPPES record for Jed Peterson was last updated on October 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 04, 2007PECOS EnrolledAccepts Medicare Assignment

84.64/100

CMS Quality Rating

10123 SE MARKET ST, DEPARTMENT OF RADIOLOGY, PORTLAND, OR 97216(503) 251-6137(503) 261-6058 Get Directions Write a Review

NPPES record last updated: October 15, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Jed Russell Peterson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JED RUSSELL PETERSON M.D. (NPI 1164634770) is an individual vascular & interventional radiology provider in Portland, Oregon, licensed in Oregon (157199) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Mid-columbia Medical Center, and is a graduate of Albany Medical College Of Union University (2006).

NPPES Registry Identity

NPI1164634770

Entity TypeIndividualMale

Primary Taxonomy2085R0204X

Provider Legal NameDR. JED RUSSELL PETERSONCredential: M.D.

Location Address10123 SE MARKET ST, DEPARTMENT OF RADIOLOGYPortland, OR 97216-2532

Mailing Address10123 Se Market St, Department Of RadiologyPortland, OR 97216-2532 · (503) 251-6137 · Fax (503) 261-6058

Phone(503) 251-6137

Fax(503) 261-6058

Sole ProprietorYes

Medical School CMSAlbany Medical College Of Union UniversityGraduated 2006

Enumeration DateMay 4, 2007

Last NPPES UpdateOctober 15, 2012

✔ NPI 1164634770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0204X

Licenses✔ Licensed in OR · 157199✔ Licensed in WA · MD.60212410

Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License MD.60212410 (WA), 157199 (OR)

10123 SE MARKET ST, Portland, OR 97216

Open in Google Maps ↗

Other Identifiers 2

Other157199OR · Oregon Medical Board

OtherMD60212410WA · Medical License Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jed Russell Peterson M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012172166

PECOS Enrollment IDI20120622000541, I20171103002363

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Jed Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Diagnostic Radiologists PC

0.1 mi

Diagnostic Radiology

10123 SE MARKET
Portland, OR 97216

Reassigned Medicare billing, Oregon enrollment
14 clinicians in this Medicare group

NPI 1053368563 (503) 251-6132

Portland Adventist Medical Center

0.1 mi

Anesthesiology

10123 SE MARKET ST
Portland, OR 97216

Reassigned Medicare billing, Oregon enrollment
331 clinicians in this Medicare group

NPI 1437925310 (503) 251-6136

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

156 services139 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

67 services62 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

47 services41 patients

X-ray of chest, 2 views 71046

29 services27 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

28 services28 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

28 services27 patients

Ultrasonic guidance for blood vessel access 76937

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

26 services24 patients

Review by radiologist of ct guidance for needle placement 77012

This process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.

21 services21 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

20 services20 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

19 services19 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

19 services18 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

18 services18 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

15 services15 patients

X-ray of hip, 2-3 views 73502

15 services15 patients

Imaging for evaluation of swallowing function 74230

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

14 services14 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

13 services12 patients

Ultrasound scan of abdominal aorta 76706

An ultrasound scan of the abdominal aorta is a non-invasive imaging test. It uses sound waves to create pictures of the main blood vessel in your abdomen, the aorta, to check its size and shape. This helps detect any abnormalities or issues early.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mid-Columbia Medical Center

Acute Care Hospitals · The Dalles, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number380001

Location1700 E 19th StreetThe Dalles, OR 97058 · Wasco County

Emergency services Birthing friendly

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number380009

Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County

Emergency services Birthing friendly

Adventist Health Portland

Acute Care Hospitals · Portland, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number380060

Location10123 SE Market StreetPortland, OR 97216 · Multnomah County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.64/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.94

Promoting Interoperability

100

Improvement Activities

Cost

62.46

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA CHRISTINE HOSEY RN

Student in an Organized Health Care Education/Training Program