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MARIAH PETERSEN APP
NPI 1336938752
Nurse Practitioner - Primary Care in Coeur D Alene, ID

Active since May 02, 2025PECOS EnrolledAccepts Medicare Assignment
1919 LINCOLN WAY STE 415, COEUR D ALENE, ID 83814(208) 625-4595 Get Directions Write a Review

NPPES record last updated: May 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mariah Petersen App NPPES

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

MARIAH PETERSEN APP (NPI 1336938752) is an individual primary care provider in Coeur D Alene, Idaho, licensed in Idaho (8771254) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1336938752
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMARIAH PETERSENCredential: APP
Location Address1919 LINCOLN WAY STE 415Coeur D Alene, ID 83814-2527
Mailing Address6225 N Cornwall StCoeur D Alene, ID 83815-5084 · (661) 447-3670 · Fax (661) 447-3670
Phone(208) 625-4595
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMay 2, 2025
NPPES CertifiedMay 2, 2025
✔ NPI 1336938752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in ID · 8771254
1919 LINCOLN WAY STE 415, Coeur D Alene, ID 83814
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mariah Petersen App 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 ID6204346752
PECOS Enrollment IDI20250612001225
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.

Hospital Affiliations CMS Care Compare

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number130049
Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
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 10

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

KRISTA TICKEMYER FNP
Nurse Practitioner
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
DAVID HENRIK JOHNSON MD
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
CALEB KELLY MD
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
MR. ADAM LEE VANSCHELT P.A.-C.
Physician Assistant
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
MATTHEW LUTE D.O.
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
DR. CHRISTOPHER MICHAEL WOOD D.O.
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
HOLLY BETH PENA ARNP
Nurse Practitioner
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
TRACE HEAVENER D.O.
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595

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 Mariah Petersen's NPI number?

The NPI number for Mariah Petersen is 1336938752. It was assigned to this individual provider in the NPPES registry on May 2, 2025.

Where is Mariah Petersen located?

Mariah Petersen practices at 1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814. The listed phone number is (208) 625-4595.

What is Mariah Petersen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Mariah Petersen enrolled in Medicare?

Yes. Mariah Petersen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mariah Petersen accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Mariah Petersen 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.

Is Mariah Petersen affiliated with any hospitals?

According to CMS data, Mariah Petersen is affiliated with Kootenai Health.

When was this NPI record last updated?

The NPPES record for Mariah Petersen was last updated on May 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.