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JEDIDIAH ALLEN PETERSEN PA
NPI 1366870206
Physician Assistant in Polson, MT

Active since October 30, 2013PECOS EnrolledAccepts Medicare Assignment
6 13TH AVE E, POLSON, MT 59860(406) 883-5680(406) 883-8960 Get Directions Write a Review

NPPES record last updated: December 8, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Jedidiah Allen Petersen Pa NPPES

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

JEDIDIAH ALLEN PETERSEN PA (NPI 1366870206) is an individual physician assistant in Polson, Montana, licensed in Idaho (PA-1110) and active in the NPI registry since October 2013. He is enrolled in Medicare PECOS, is affiliated with St. Patrick Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1366870206
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJEDIDIAH ALLEN PETERSENCredential: PA
Location Address6 13TH AVE EPolson, MT 59860-5315
Mailing AddressPo Box 262Liberty Lake, WA 99019-0262 · (208) 232-7862 · Fax (208) 232-7869
Phone(406) 883-5680
Fax(406) 883-8960
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 30, 2013
Last NPPES UpdateDecember 8, 2015
✔ NPI 1366870206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · PA-1110
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
6 13TH AVE E, Polson, MT 59860
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and more.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

Jedidiah Allen Petersen Pa 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 ID3779706551
PECOS Enrollment IDI20151209002109
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 3

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

St. Patrick Hospital

Acute Care Hospitals · Missoula, MT
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number270014
Location500 W BroadwayMissoula, MT 59806 · Missoula County
Emergency services Birthing friendly

St Luke Community Hospital

Critical Access Hospitals · Ronan, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271325
Location107 6th Ave SWRonan, MT 59864 · Lake County
Emergency services

Providence St Joseph Medical Center

Critical Access Hospitals · Polson, MT
OwnershipVoluntary non-profit - Private
CMS Certification Number271343
Location6 13th Ave EPolson, MT 59860 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59860 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
$87.97 typical visit price
range $56.81 – $172.26
Typical copayment $21.99 (range $14.20 – $43.06)
Most-billed visit code 99203
Established Patient
$70.82 typical visit price
range $18.24 – $140.32
Typical copayment $17.70 (range $4.56 – $35.08)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$119.34 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers13 claims13 services$18.03 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ANGELA LEMIRE PA-C
Physician Assistant
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
MATTHEW JOSEPH ANDERSON
Orthopaedic Surgery
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
DR. DARREN BROCKIE M.D.
Emergency Medicine
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
CREDENA HEALTH LLC
Pharmacy (Community/Retail Pharmacy)
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-8444
TIMOTHY W. THORNTON PA-C
Physician Assistant
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
EUGENE BEVILLE
Emergency Medicine
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
SHEILA REASH CRNA
Nurse Anesthetist, Certified Registered
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680
SCOT A SWANSON M.D,
Family Medicine
6 13TH AVE E
POLSON, MT 59860
Lake County (406) 883-5680

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 Jedidiah Petersen's NPI number?

The NPI number for Jedidiah Petersen is 1366870206. It was assigned to this individual provider in the NPPES registry on October 30, 2013.

Where is Jedidiah Petersen located?

Jedidiah Petersen practices at 6 13th Ave E, Polson, MT 59860. The listed phone number is (406) 883-5680.

What is Jedidiah Petersen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jedidiah Petersen enrolled in Medicare?

Yes. Jedidiah 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 Jedidiah Petersen accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and Providence Health Plan list Jedidiah 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 Jedidiah Petersen affiliated with any hospitals?

According to CMS data, Jedidiah Petersen is affiliated with St. Patrick Hospital, St Luke Community Hospital and Providence St Joseph Medical Center.

When was this NPI record last updated?

The NPPES record for Jedidiah Petersen was last updated on December 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.