JESSE FREDERICK PETERSON PSYD
NPI 1457996910
Psychologist in Green Bay, WI

Active since November 08, 2019PECOS EnrolledAccepts Medicare Assignment
301 E SAINT JOSEPH ST, GREEN BAY, WI 54301(920) 433-6073(920) 431-0333 Get Directions Write a Review

NPPES record last updated: November 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2019, Nov 8, 2019 (2 updates tracked since 2019).

About Jesse Frederick Peterson Psyd NPPES

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

JESSE FREDERICK PETERSON PSYD (NPI 1457996910) is an individual psychologist in Green Bay, Wisconsin, licensed in Wisconsin (3690-57) and active in the NPI registry since November 2019. He is enrolled in Medicare PECOS, is affiliated with Bellin Memorial Hospital, and maintains a secondary practice location in Green Bay.

NPPES Registry Identity

NPI1457996910
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJESSE FREDERICK PETERSONCredential: PSYD
Location Address301 E SAINT JOSEPH STGreen Bay, WI 54301-2241
Mailing AddressPo Box 22040Green Bay, WI 54305-2040 · (920) 445-7222 · Fax (920) 445-7289
Fax(920) 431-0333
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 8, 2019
Last NPPES UpdateNovember 11, 20192 updates tracked since enumeration
NPI 1457996910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WI · 3690-57
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
301 E SAINT JOSEPH ST, Green Bay, WI 54301

Secondary Practice Location 1

Location 1725 S Webster AveGreen Bay, WI 54301-3500 · Phone (920) 433-6073 · Fax (920) 431-0333

Accepted 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

Jesse Frederick Peterson Psyd 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 ID7113359910
PECOS Enrollment IDI20191116000147
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 5

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.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes 96139
This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.
223 services42 patients
Evaluation of neuropsychological test, each additional hour 96133
This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.
94 services47 patients
Exam of neurobehavioral status, first hour 96116
An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.
50 services50 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
49 services49 patients
Administration of psychological or neuropsychological test by technician, first 30 minutes 96138
This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.
42 services42 patients

Hospital Affiliations CMS Care Compare

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

Bellin Memorial Hospital

Acute Care Hospitals · Green Bay, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520049
Location744 S Webster AveGreen Bay, WI 54305 · Brown 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.

Psychiatry & Neurology (Psychiatry)
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Counselor
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Social Worker (Clinical)
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Psychologist
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Nurse Practitioner (Psychiatric/Mental Health)
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Psychologist
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Counselor (Professional)
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301
Social Worker (Clinical)
301 E SAINT JOSEPH ST
GREEN BAY, WI 54301

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 Jesse Peterson's NPI number?

The NPI number for Jesse Peterson is 1457996910. It was assigned to this individual provider in the NPPES registry on November 8, 2019.

Where is Jesse Peterson located?

Jesse Peterson practices at 301 E Saint Joseph St, Green Bay, WI 54301. The listed phone number is (920) 433-6073.

What is Jesse Peterson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jesse Peterson enrolled in Medicare?

Yes. Jesse Peterson 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 Jesse Peterson accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners, Medica and UnitedHealthcare list Jesse 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.

Is Jesse Peterson affiliated with any hospitals?

According to CMS data, Jesse Peterson is affiliated with Bellin Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jesse Peterson was last updated on November 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.