MRS. JOHANNA RAE PETERSON PA-C
NPI 1396934238
Physician Assistant - Medical in Bend, OR

Q: What is Johanna Peterson's NPI number?

The NPI number for Johanna Peterson is 1396934238. It was assigned to this individual provider in the NPPES registry on October 16, 2007. The provider is also known as Johanna Rae Godell Pa-C.

Q: What is Johanna Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Johanna Peterson was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.

Active since October 16, 2007PECOS EnrolledAccepts Medicare Assignment

2200 NE NEFF RD STE 302, BEND, OR 97701(541) 706-4220 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 17, 2024, Nov 3, 2022, Nov 3, 2020 and 1 more (4 updates tracked since 2020).

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About Mrs. Johanna Rae Peterson Pa-c NPPES

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

MRS. JOHANNA RAE PETERSON PA-C (NPI 1396934238) is an individual medical provider in Bend, Oregon, licensed in Oregon (PA01280) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS, is affiliated with St Charles Medical Center - Bend, and maintains a secondary practice location in Albany.

NPPES Registry Identity

NPI1396934238

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. JOHANNA RAE PETERSONCredential: PA-C

Location Address2200 NE NEFF RD STE 302Bend, OR 97701-4279

Mailing AddressPo Box 1188Corvallis, OR 97339-1188

Phone(541) 706-4220

Sole ProprietorNo

Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2007

Enumeration DateOctober 16, 2007

Last NPPES UpdateSeptember 17, 20244 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2024

✔ NPI 1396934238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in OR · PA01280

2200 NE NEFF RD STE 302, Bend, OR 97701

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Other Names 1

Former Name (1)Johanna Rae Godell Pa-c

Secondary Practice Location 1

Location 1400 Hickory St NW Ste 303Albany, OR 97321-1700 · Phone (541) 812-5275

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.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

Mrs. Johanna Rae Peterson Pa-c 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 ID1951481092

PECOS Enrollment IDI20080102000463

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.

Areas of Expertise CMS Part B claims 8

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

153 services146 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

90 services88 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

51 services51 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

31 services31 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

23 services23 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.

22 services22 patients

Hospital Affiliations CMS Care Compare 4

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

St Charles Medical Center - Bend

Acute Care Hospitals · Bend, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380047

Location2500 NE Neff RoadBend, OR 97701 · Deschutes County

Emergency services Birthing friendly

Sky Lakes Medical Center

Acute Care Hospitals · Klamath Falls, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380050

Location2865 Daggett AvenueKlamath Falls, OR 97601 · Klamath County

Emergency services

St Charles Medical Center Prineville

Critical Access Hospitals · Prineville, OR

OwnershipVoluntary non-profit - Private

CMS Certification Number381313

Location384 SE Combs Flat RoadPrineville, OR 97754 · Crook County

Emergency services

St Charles Madras

Critical Access Hospitals · Madras, OR

OwnershipVoluntary non-profit - Private

CMS Certification Number381324

Location470 NE A StreetMadras, OR 97741 · Jefferson County

Emergency services Birthing friendly

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.

MS. DEBORA ANN LEONARDO FNP-BC

Nurse Practitioner (Family)