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JOHNATHAN L. PETERSON PA-C
NPI 1568538742
Physician Assistant in San Antonio, TX

Active since November 28, 2006PECOS EnrolledAccepts Medicare Assignment
204 E FAIR OAKS PL, SAN ANTONIO, TX 78209(210) 315-4601 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Johnathan L. Peterson Pa-c NPPES

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

JOHNATHAN L. PETERSON PA-C (NPI 1568538742) is an individual physician assistant in San Antonio, Texas, licensed in Texas (PA05099) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1568538742
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOHNATHAN L. PETERSONCredential: PA-C
Location Address204 E FAIR OAKS PLSan Antonio, TX 78209-3811
Mailing Address204 E Fair Oaks PlSan Antonio, TX 78209-3811 · (210) 315-4601
Phone(210) 315-4601
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateNovember 28, 2006
Last NPPES UpdateFebruary 6, 2025
NPPES CertifiedFebruary 6, 2025
✔ NPI 1568538742 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 TX · PA05099
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.
204 E FAIR OAKS PL, San Antonio, TX 78209
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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

Johnathan L. 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 ID547366874
PECOS Enrollment IDI20250304003743
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78209 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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

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

ELEVATED MEDICAL SERVICES
Physician Assistant
204 E FAIR OAKS PL
ALAMO HEIGHTS, TX 78209
Bexar County (210) 315-4601

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 Johnathan Peterson's NPI number?

The NPI number for Johnathan Peterson is 1568538742. It was assigned to this individual provider in the NPPES registry on November 28, 2006.

Where is Johnathan Peterson located?

Johnathan Peterson practices at 204 E Fair Oaks Pl, San Antonio, TX 78209. The listed phone number is (210) 315-4601.

What is Johnathan Peterson's specialty?

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

Is Johnathan Peterson enrolled in Medicare?

Yes. Johnathan 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.

When was this NPI record last updated?

The NPPES record for Johnathan Peterson was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.