JORDAN MICHAEL PETERSEN MD
NPI 1952989816
Emergency Medicine in Portland, OR

Q: What is Jordan Petersen's NPI number?

The NPI number for Jordan Petersen is 1952989816. It was assigned to this individual provider in the NPPES registry on March 31, 2021.

Q: What is Jordan Petersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jordan Petersen was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since March 31, 2021PECOS EnrolledAccepts Medicare Assignment

9205 SW BARNES RD, PORTLAND, OR 97225(503) 216-1234 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 5, 2025, Mar 31, 2021 (2 updates tracked since 2021).

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About Jordan Michael Petersen Md NPPES

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

JORDAN MICHAEL PETERSEN MD (NPI 1952989816) is an individual emergency medicine provider in Portland, Oregon, licensed in Oregon (MD223168) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Harvard Medical School (2021).

NPPES Registry Identity

NPI1952989816

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameJORDAN MICHAEL PETERSENCredential: MD

Location Address9205 SW BARNES RDPortland, OR 97225-6603

Mailing Address2121 Nw Raleigh St Apt 130Portland, OR 97210-2148 · (503) 869-3609

Phone(503) 216-1234

Sole ProprietorNo

Medical School CMSHarvard Medical SchoolGraduated 2021

Enumeration DateMarch 31, 2021

Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration

NPPES CertifiedAugust 5, 2025

✔ NPI 1952989816 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 · MD223168

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.

9205 SW BARNES RD, Portland, OR 97225

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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

Jordan Michael Petersen Md 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 ID4880119304

PECOS Enrollment IDI20250417000792

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.

Hospital Affiliations CMS Care Compare

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

Providence St Vincent Medical Center

Acute Care Hospitals · Portland, OR

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380004

Location9205 SW Barnes RoadPortland, OR 97225 · Washington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97225 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

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$103.51 typical visit price

range $19.32 – $144.79

Typical copayment $25.87 (range $4.83 – $36.19)

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.

DR. VICTOR NGUYEN PHAM M.D.

Hospitalist