Jared M Petersen, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Richland, Washington. His current practice location is
940 Northgate Dr, Richland, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 942-2516.
Jared M Petersen is licensed to practice in Washington (license number OL61438195) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285327841.
Physician's Profile
Full Name | Jared M Petersen |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 940 Northgate Dr, Richland, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1285327841
- Provider Enumeration Date: 05/31/2023
- Last Update Date: 05/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 6204297765
- Enrollment ID: I20230731002585
Medical Identifiers
Medical identifiers for Jared M Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1285327841 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | OL61438195 (Washington) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | OL61438195 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jared M Petersen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jared M Petersen, DO 550 Gage Blvd Ste 101, Richland, WA 99352-9532 Ph: (509) 946-4611 | Jared M Petersen, DO 940 Northgate Dr, Richland, WA 99352-3505 Ph: (509) 942-2516 |
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