OWEN PETERSEN PA
NPI 1457896300
Physician Assistant - Surgical in Albany, NY

NPI Status: Active since January 02, 2017

Contact Information

121 EVERETT RD
ALBANY, NY
ZIP 12205
Phone: (518) 489-2663
Fax: (518) 689-3881

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  • Individual
  • Male
  • Years of Experience 5
  • Physician Assistant
  • Surgical
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About OWEN PETERSEN

This page provides the complete NPI Profile along with additional information for Owen Petersen, a provider established in Albany, New York with a medical specialization in Physician Assistant, focusing in surgical and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1457896300 assigned on January 2017. The practitioner's primary taxonomy code is 363AS0400X with license number 027272 (NY). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1457896300
Provider Name
OWEN PETERSEN PA
Gender
Male
Entity Type
Individual
Location Address
121 EVERETT RD ALBANY, NY 12205
Location Phone
(518) 489-2663
Location Fax
(518) 689-3881
Mailing Address
121 EVERETT RD ALBANY, NY 12205
Mailing Phone
(518) 489-2663
Mailing Fax
(518) 689-3881
Medical School Name
OTHER
Graduation Year
2021
Is Sole Proprietor?
No
Enumeration Date
01-02-2017
Last Update Date
07-16-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
027272
License State
NY

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Specialist/Technologist
Athletic Trainer

 
2363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

027272 (NY)
3390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
06817683MEDICAID (05)NY 

Medicare Participation & PECOS Enrollment Status

Owen Petersen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Owen Petersen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6103214135

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20211025002477

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Application of elbow to finger cast

An elbow to finger cast is applied to immobilize the arm from the elbow down to the fingers. This aids in healing fractures or severe sprains. The cast, made from plaster or fiberglass, wraps around the arm, providing support and limiting movement to promote recovery.

This service was performed 23 times for 19 patients

Aspiration and/or injection of fluid from small joint

This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.

This service was performed 17 times for 12 patients

Cast supplies, short arm cast, adult (11 years +), fiberglass

A short arm cast, made from fiberglass, is often used for fractures or injuries to the wrist or forearm in adults and children over 11. It's lightweight, durable, and can be molded to fit your arm comfortably. This cast allows for limited movement while ensuring proper healing.

This service was performed 22 times for 18 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 188 times for 111 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 24 times for 18 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 17 times for 14 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 62 times for 40 patients

X-ray of hand, minimum of 3 views

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

This service was performed 74 times for 34 patients

X-ray of shoulder, minimum of 2 views

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

This service was performed 22 times for 12 patients

X-ray of wrist, minimum of 3 views

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

This service was performed 37 times for 19 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Owen Petersen is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST PETER'S HOSPITAL315 SOUTH MANNING BOULEVARD
ALBANY, NY 12208
(518) 525-1550Acute Care Hospitals
SAMARITAN HOSPITAL OF TROY, NEW YORK2215 BURDETT AVENUE
TROY, NY 12180
(518) 427-3402Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1457896300, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
7
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
3
Unchanged
Pos 9
0
Doubled → 0
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 8 → 16 → 7 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 0 + 7 + 1 + 6 + 9 + 1 + 2 + 3 + 0 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1457896300.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Specialist
121 EVERETT RD, STE 220
ALBANY, NY 12205
Nurse Practitioner (Adult Health)
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant
121 EVERETT RD
ALBANY, NY 12205
Physical Therapist
121 EVERETT RD
ALBANY, NY 12205
Physical Therapist
121 EVERETT RD
ALBANY, NY 12205
Specialist/Technologist (Athletic Trainer)
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant (Surgical)
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant (Surgical)
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Physical Therapist
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant (Surgical)
121 EVERETT RD
ALBANY, NY 12205
Physical Therapist
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant (Surgical)
121 EVERETT RD
ALBANY, NY 12205
Orthopaedic Surgery
121 EVERETT RD
ALBANY, NY 12205
Physician Assistant
121 EVERETT RD
ALBANY, NY 12205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457896300, enumerated as an "individual" on January 02, 2017.

The provider is located at 121 EVERETT RD ALBANY, NY 12205 and the phone number is (518) 489-2663.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Owen Petersen is affiliated with: ST PETER'S HOSPITAL and SAMARITAN HOSPITAL OF TROY, NEW YORK.