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DR. SHANE EMBER PETERSON M.D.
NPI 1881919918
Emergency Medicine in Salem, OR

Active since March 31, 2010PECOS Enrolled
890 OAK ST SE, SALEM, OR 97301(503) 814-1278 Get Directions Write a Review

NPPES record last updated: May 3, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Shane Ember Peterson M.d. NPPES

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

DR. SHANE EMBER PETERSON M.D. (NPI 1881919918) is an individual emergency medicine provider in Salem, Oregon, licensed in Oregon (MD171431) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881919918
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. SHANE EMBER PETERSONCredential: M.D.
Location Address890 OAK ST SESalem, OR 97301-3905
Mailing Address890 Oak St SeSalem, OR 97301-3905 · (503) 814-1278
Phone(503) 814-1278
Sole ProprietorNo
Enumeration DateMarch 31, 2010
Last NPPES UpdateMay 3, 2018
✔ NPI 1881919918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in OR · MD171431
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
890 OAK ST SE, Salem, OR 97301
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shane Ember Peterson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Shane Peterson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Salem Emergency Physicians Service, PC
Same address
Emergency Medicine
890 OAK STREET, SE BUILDING 'A'
Salem, OR 97301
  • Reassigned Medicare billing, Oregon enrollment
  • 47 clinicians in this Medicare group
NPI 1063454395 (503) 561-5634
Salem Health
Same address
General Acute Care Hospital
890 OAK ST SE
Salem, OR 97301
  • Reassigned Medicare billing, Oregon enrollment
  • 625 clinicians in this Medicare group
NPI 1265431829 (503) 561-5200
Salem Health West Valley
14 mi
Critical Access
525 SE WASHINGTON ST
Dallas, OR 97338
  • Reassigned Medicare billing, Oregon enrollment
  • 254 clinicians in this Medicare group
NPI 1245237486 (503) 623-8301

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
233 services225 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
117 services109 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
91 services77 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
27 services27 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97301 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
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 20

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

JORDAN L BARNHART M.D.
Emergency Medicine
890 OAK ST SE, BUILDING 'A'
SALEM, OR 97301
Marion County (503) 814-1278
DR. QUINCY ENYIOMA JOHN MD
Family Medicine (Sports Medicine)
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 814-1879
JACOB NICHOLSON N.P.
Nurse Practitioner (Family)
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 814-2154
DR. CHANDRA MANNYAM MD
Psychiatry & Neurology (Neurology)
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 814-7554
YUNFEI ZENG
Registered Nurse
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 561-5200
JOSH BREHM RN
Registered Nurse (Emergency)
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 779-3530
JULIE MARIE HAYNES
Student in an Organized Health Care Education/Training Program
890 OAK ST SE
SALEM, OR 97301
Marion County (503) 561-5200
TREVOR GRANT PHILLIPS M.D.
Emergency Medicine
890 OAK ST SE, SALEM EMERGENCY PHYSICIANS C/O ED - SALEM HOSPITAL 'A'
SALEM, OR 97301
Marion County (503) 561-5634

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 Shane Peterson's NPI number?

The NPI number for Shane Peterson is 1881919918. It was assigned to this individual provider in the NPPES registry on March 31, 2010.

Where is Shane Peterson located?

Shane Peterson practices at 890 Oak St SE, Salem, OR 97301. The listed phone number is (503) 814-1278.

What is Shane Peterson's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Shane Peterson enrolled in Medicare?

Yes. Shane Peterson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shane Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Peterson reassigns Medicare benefits to 3 organizations: Salem Emergency Physicians Service, PC (Salem, OR), Salem Health (Salem, OR) and Salem Health West Valley (Dallas, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shane Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shane Peterson was last updated on May 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.