Mr Wiley D Petersen, PA-C in Chubbuck, ID - Medicare Physician Assistant

Mr Wiley D Petersen, PA-C is a medicare enrolled "Physician Assistant" in Chubbuck, Idaho. He graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Mvh Pic Llc and his current practice location is 134 W Chubbuck Rd, Chubbuck, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 417-0102.

Mr Wiley D Petersen is licensed to practice in Idaho (license number PA-1714) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568920080.

Contact Information

	Mr Wiley D Petersen, PA-C
	134 W Chubbuck Rd, Chubbuck, ID 83202-2338
	(208) 417-0102
	(208) 242-3219

Map and Direction

Provider's Profile

Full Name	Mr Wiley D Petersen
Gender	Male
Speciality	Physician Assistant
Experience	6 Years
Location	134 W Chubbuck Rd, Chubbuck, Idaho
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Wiley D Petersen graduated from nursing school in 2018

NPI Data:

NPI Number: 1568920080
Provider Enumeration Date: 03/04/2019
Last Update Date: 05/17/2024

Medicare PECOS Information:

PECOS PAC ID: 7618209156
Enrollment ID: I20230127001008

Medical Identifiers

Medical identifiers for Mr Wiley D Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1568920080	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA-1714 (Idaho)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mountain View Hospital	Idaho falls, ID	Hospital
Portneuf Medical Center	Pocatello, ID	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mvh Pic Llc	6709156904	16

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. Mr Wiley D 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
Mr Wiley D Petersen, PA-C 5014 Mary Ln, Pocatello, ID 83202-1679 Ph: (208) 241-5819	Mr Wiley D Petersen, PA-C 134 W Chubbuck Rd, Chubbuck, ID 83202-2338 Ph: (208) 417-0102

Reviews and Comments

Physician Assistant Nurses in Chubbuck, ID

Renee Lynn Katter, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 4460 Kings Way Ste 3, Chubbuck, ID 83202 Phone: 208-237-3612 Fax: 208-237-5192
Brookelle Smith Gunn, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 880 W Quinn Rd, Chubbuck, ID 83202 Phone: 208-238-2000
Mrs. Rachel M Koster, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4650 Hawthorne Road,, Suite 3b, Chubbuck, ID 83202 Phone: 208-237-9833
Michaela Sophia Butler, PA-S Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4650 Hawthorne Rd Ste 3b, Chubbuck, ID 83202 Phone: 208-252-5621 Fax: 208-648-4167
Ryan Daniel Wolfley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4650 Hawthorne Rd Ste 3b, Chubbuck, ID 83202 Phone: 208-252-5621 Fax: 208-648-4167
Ryan T Mcculloch, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 147 W Chubbuck Rd, Chubbuck, ID 83202 Phone: 208-238-7546 Fax: 208-237-9643

Mr Wiley D Petersen, PA-C - Medicare Physician Assistant in Chubbuck, ID