EMILY PETERSEN PA-C
NPI 1720658354
Physician Assistant in Ochelata, OK

Q: What is Emily Petersen's NPI number?

The NPI number for Emily Petersen is 1720658354. It was assigned to this individual provider in the NPPES registry on June 27, 2021.

Q: What is Emily Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Emily Petersen was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 27, 2021PECOS EnrolledAccepts Medicare Assignment

78.75/100

CMS Quality Rating

395200 W 2900 RD, OCHELATA, OK 74051(918) 535-6000 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 9, 2022, Jun 27, 2021 (2 updates tracked since 2021).

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About Emily Petersen Pa-c NPPES

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

EMILY PETERSEN PA-C (NPI 1720658354) is an individual physician assistant in Ochelata, Oklahoma, licensed in Oklahoma (4779) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Ascension St John Jane Phillips, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1720658354

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameEMILY PETERSENCredential: PA-C

Location Address395200 W 2900 RDOchelata, OK 74051-2463

Mailing Address11208 W 50th StShawnee, KS 66203-1547 · (913) 238-7424

Phone(918) 535-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 27, 2021

Last NPPES UpdateJune 9, 20222 updates tracked since enumeration

NPPES CertifiedJune 7, 2022

✔ NPI 1720658354 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 OK · 4779

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.

395200 W 2900 RD, Ochelata, OK 74051

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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

Emily Petersen 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 ID6901288349

PECOS Enrollment IDI20220802003130

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 2

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 moderate level of decision making, if using time, 30 minutes or more 99214

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.

234 services136 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.

76 services66 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension St John Jane Phillips

Acute Care Hospitals · Bartlesville, OK

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370018

Location3500 East Frank Phillips BoulevardBartlesville, OK 74006 · Washington County

Emergency services Birthing friendly

Ascension St John Medical Center

Acute Care Hospitals · Tulsa, OK

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number370114

Location1923 South Utica AvenueTulsa, OK 74104 · Tulsa County

Emergency services Birthing friendly

Cherokee Nation W W Hastings Indian Hospital

Acute Care Hospitals · Tahlequah, OK

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number370171

Location100 S Bliss AvenueTahlequah, OK 74464 · Cherokee County

Emergency services Birthing friendly

Claremore Indian Hospital

Acute Care Hospitals · Claremore, OK

OwnershipGovernment - Federal

CMS Certification Number370173

Location101 South Moore AveClaremore, OK 74017 · Rogers County

Emergency services Birthing friendly

Bailey Medical Center, LLC

Acute Care Hospitals · Owasso, OK

OwnershipProprietary

CMS Certification Number370228

Location10502 North 110th East AvenueOwasso, OK 74055 · Tulsa County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74051 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

61.59

Promoting Interoperability

Improvement Activities

Cost

65.11

Other Providers at the Same Location NPPES 12

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

BAILEE ROWLETT

Nurse Practitioner (Family)