DR. PRESTON LANE PETERSON MD
NPI 1245201508
Internal Medicine - Geriatric Medicine in Portland, OR

Q: What is Preston Peterson's NPI number?

The NPI number for Preston Peterson is 1245201508. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Q: What is Preston Peterson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Q: When was this NPI record last updated?

The NPPES record for Preston Peterson was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 January 26, 2006PECOS Enrolled

2701 NW VAUGHN ST, SUITE 160, PORTLAND, OR 97210(503) 499-5200(503) 499-5455 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Preston Lane Peterson Md NPPES

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

DR. PRESTON LANE PETERSON MD (NPI 1245201508) is an individual geriatric medicine provider in Portland, Oregon, licensed in Oregon (MD25733) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245201508

Entity TypeIndividualMale

Primary Taxonomy207RG0300X

Provider Legal NameDR. PRESTON LANE PETERSONCredential: MD

Location Address2701 NW VAUGHN ST, SUITE 160Portland, OR 97210-5311

Mailing Address2701 Nw Vaughn St, Suite 160Portland, OR 97210-5311 · (503) 499-5200 · Fax (503) 499-5455

Phone(503) 499-5200

Fax(503) 499-5455

Sole ProprietorNo

Enumeration DateJanuary 26, 2006

Last NPPES UpdateFebruary 4, 2022

✔ NPI 1245201508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RG0300X

Licenses✔ Licensed in OR · MD25733✔ Licensed in WA · MD60167468

Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

2701 NW VAUGHN ST, Portland, OR 97210

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Preston Lane Peterson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Preston Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Northwest

1.3 mi

General Practice

1035 NW NORTHRUP ST
Portland, OR 97209

Reassigned Medicare billing, Oregon and Washington enrollments
Also billed through NPI 1184786527 (Washington)
3,207 clinicians in this Medicare group

NPI 1649722034 (800) 813-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97210 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

$176.88 typical visit price

range $58.99 – $176.88

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

Most-billed visit code 99205

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

Most-billed visit code 99214

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

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.

JENI LYNNE SHILMAN LCSW

Social Worker (Clinical)

2701 NW VAUGHN ST
PORTLAND, OR 97210

Multnomah County (503) 499-5200

ARTHUR D HAYWARD MD

Internal Medicine (Geriatric Medicine)

2701 NW VAUGHN ST
PORTLAND, OR 97210

Multnomah County (503) 499-5200

MISS MOLLY TERECIA MEADOWS BS

Physical Therapist

2701 NW VAUGHN ST
PORTLAND, OR 97210

Multnomah County (503) 721-6800

MS. MARY KRISTINE HORTON A.N.P.

Registered Nurse

2701 NW VAUGHN ST, #305
PORTLAND, OR 97210

Multnomah County (503) 279-8252

MELISSA VIDONI DPT

Physical Therapist

2701 NW VAUGHN ST, SUITE 140
PORTLAND, OR 97210

Multnomah County (571) 332-7777

BRIAN S STURGILL MPT

Physical Therapist

2701 NW VAUGHN ST, SUITE 140
PORTLAND, OR 97210

Multnomah County (503) 499-5200

MARCIA BERTALOT ANP

Nurse Practitioner (Adult Health)

2701 NW VAUGHN ST
PORTLAND, OR 97210

Multnomah County (503) 499-5200

FRANCISCO RODRIGUEZ OT

Occupational Therapist

2701 NW VAUGHN ST, SUITE 140
PORTLAND, OR 97210

Multnomah County (503) 499-5148

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Preston Peterson's NPI number?

The NPI number for Preston Peterson is 1245201508. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Where is Preston Peterson located?

Preston Peterson practices at 2701 NW Vaughn St Suite 160, Portland, OR 97210. The listed phone number is (503) 499-5200.

What is Preston Peterson's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Preston Peterson enrolled in Medicare?

Yes. Preston Peterson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Preston Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Preston Peterson reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Preston Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Preston Peterson accept?

Health plans from Kaiser Permanente list Preston Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Preston Peterson was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.