JODI PETERSON
NPI 1659767184
Counselor - Mental Health in Bend, OR

Active since April 10, 2015Opted out of Medicare · through Jan 1, 2028
1195 NW WALL ST, BEND, OR 97703(541) 728-0062 Get Directions Write a Review

NPPES record last updated: December 5, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jodi Peterson NPPES

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

JODI PETERSON (NPI 1659767184) is an individual mental health provider in Bend, Oregon and active in the NPI registry since April 2015. She has opted out of Medicare through January 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1659767184
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJODI PETERSON
Location Address1195 NW WALL STBend, OR 97703-1965
Mailing Address3995 Marcola RdSpringfield, OR 97477-7948 · (541) 726-1465
Sole ProprietorNo
Enumeration DateApril 10, 2015
Last NPPES UpdateDecember 5, 2016
NPI 1659767184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1195 NW WALL ST, Bend, OR 97703

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jodi Peterson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 4

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

Counselor (Mental Health)
1195 NW WALL ST
BEND, OR 97703
Peer Specialist
1195 NW WALL ST
BEND, OR 97703
Marriage & Family Therapist
1195 NW WALL ST
BEND, OR 97703
Counselor (Mental Health)
1195 NW WALL ST
BEND, OR 97703

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 Jodi Peterson's NPI number?

The NPI number for Jodi Peterson is 1659767184. It was assigned to this individual provider in the NPPES registry on April 10, 2015.

Where is Jodi Peterson located?

Jodi Peterson practices at 1195 NW Wall St, Bend, OR 97703. The listed phone number is (541) 728-0062.

What is Jodi Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jodi Peterson enrolled in Medicare?

No. Jodi Peterson has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Jodi Peterson accept?

Health plans from PacificSource Health Plans and Providence Health Plan list Jodi 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.

When was this NPI record last updated?

The NPPES record for Jodi Peterson was last updated on December 5, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.