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MR. SHAUN M PETERSEN PA
NPI 1497911556
Physician Assistant in North Logan, UT

Active since July 29, 2008PECOS EnrolledAccepts Medicare Assignment
2310 N 400 E, STE A, NORTH LOGAN, UT 84341(435) 787-2000(435) 787-1913 Get Directions Write a Review

NPPES record last updated: October 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 1, 2021, Nov 11, 2015 (2 updates tracked since 2015).

About Mr. Shaun M Petersen Pa NPPES

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

MR. SHAUN M PETERSEN PA (NPI 1497911556) is an individual physician assistant in North Logan, Utah, licensed in Utah (7036833-1206) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Mckay-dee Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1497911556
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. SHAUN M PETERSENCredential: PA
Location Address2310 N 400 E, STE ANorth Logan, UT 84341-1788
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128 · (435) 890-9466
Phone(435) 787-2000
Fax(435) 787-1913
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 29, 2008
Last NPPES UpdateOctober 1, 20212 updates tracked since enumeration
NPPES CertifiedOctober 1, 2021
✔ NPI 1497911556 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 UT · 7036833-1206
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.
2310 N 400 E, North Logan, UT 84341
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Mr. Shaun M 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 ID8729153804
PECOS Enrollment IDI20080825000489
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 3

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 straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
33 services28 patients
X-ray of thigh bone, minimum 2 views 73552
An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.
21 services18 patients
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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Mckay-Dee Hospital

Acute Care Hospitals · Ogden, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460004
Location4401 Harrison BoulevardOgden, UT 84403 · Weber County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84341 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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.

Other Providers at the Same Location NPPES 16

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

CHARLES R ACEVEDO PT
Physical Therapist
2310 N 400 E, STE C
NORTH LOGAN, UT 84341
Cache County (435) 752-5200
DR. GREGORY J HICKEN M.D.
Orthopaedic Surgery
2310 N 400 E, STE A
LOGAN, UT 84341
Cache County (435) 787-2000
DR. KEITH J NELSON M.D.
Orthopaedic Surgery
2310 N 400 E, STE A
LOGAN, UT 84341
Cache County (435) 787-2000
DR. TERRY I FINLAYSON MD
Orthopaedic Surgery
2310 N 400 E
LOGAN, UT 84341
Cache County (435) 787-2000
BRAD J LARSON MD
Orthopaedic Surgery
2310 N 400 E, STE A
LOGAN, UT 84341
Cache County (435) 787-2000
ALPINE MANAGEMENT AND CONSULTING
Orthopaedic Surgery (Sports Medicine)
2310 N 400 E, SUITE A
LOGAN, UT 84341
Cache County (435) 787-2000
JASON M CHRISTIANSEN DPT
Physical Therapist
2310 N 400 E, STE C
NORTH LOGAN, UT 84341
Cache County (435) 752-5200
MICHAEL LUKE CLEGG MD
Physical Medicine & Rehabilitation
2310 N 400 E, STE A
LOGAN, UT 84341
Cache County (435) 787-2000

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 Shaun Petersen's NPI number?

The NPI number for Shaun Petersen is 1497911556. It was assigned to this individual provider in the NPPES registry on July 29, 2008.

Where is Shaun Petersen located?

Shaun Petersen practices at 2310 N 400 E Ste A, North Logan, UT 84341. The listed phone number is (435) 787-2000.

What is Shaun Petersen's specialty?

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

Is Shaun Petersen enrolled in Medicare?

Yes. Shaun 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 Shaun Petersen accept?

Health plans from Select Health list Shaun 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 Shaun Petersen affiliated with any hospitals?

According to CMS data, Shaun Petersen is affiliated with Mckay-Dee Hospital.

When was this NPI record last updated?

The NPPES record for Shaun Petersen was last updated on October 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.