Jason Marc Petersen (NPI# 1407235948, PAC ID# 7517275621) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1407235948 |
| PAC ID by PECOS | 7517275621 |
| Professional Enrollment ID | I20151008002097 |
| Full Name | Jason Marc Petersen |
| Organization Legal Name | EYE CLINIC OF SANDPOINT PA |
| Address |
307 S 1st Ave Sandpoint ID 83864-1201 |
| Phone Number | 2082638501 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 2015 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 3678541018 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 307 S 1st Ave, Sandpoint, ID 83864-1201 | 2082638501 | EYE CLINIC OF SANDPOINT PA |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% |
| Organization Legal Name | EYE CLINIC OF SANDPOINT PA |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce D Bellin | Ophthalmology | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Brayden Grant Petersen | Optometry | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Charles C George | Ophthalmology | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Street Address |
307 S 1ST AVE |
| City | SANDPOINT |
| State | ID |
| Zip | 83864-1201 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce D Bellin | Ophthalmology | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Brayden Grant Petersen | Optometry | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Charles C George | Ophthalmology | Eye Clinic of Sandpoint Pa | 307 S 1st Ave, Sandpoint, ID 83864-1201 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shawna Benner Erickson | Physical Therapy | 1005 Hwy 2 W, Sandpoint, ID 83864 | |
| Kathryn C Robertson | Nurse Practitioner | Sandpoint Family Medicine | 302 S 1st Ave, Sandpoint, ID 83864-1258 |
| Mark A Hernandez | Family Medicine | Sandpoint Family Medicine | 302 S 1st Ave, Sandpoint, ID 83864-1258 |
| Brett D Oconnor | Nurse Practitioner | Sandpoint Family Medicine | 302 S 1st Ave, Sandpoint, ID 83864-1258 |
| Don C. H. Henker | Optometry | Drs. D and W Henker, P.C. | 123 S 3rd Ave, Suite 1, Sandpoint, ID 83864-1358 |
| Geoffrey D Greenway | Chiropractic | 123 S 3rd Ave, Suite 6, Sandpoint, ID 83864-1358 | |
| Whitney Camille Henker | Optometry | Drs. D and W Henker, P.C. | 123 S 3rd Ave, Suite 1, Sandpoint, ID 83864-1358 |
| Gloria J Waterhouse | Psychologist, Clinical | 100 N 1st Ave, Sandpoint, ID 83864-1376 | |
| Virginia Maus | Clinical Social Worker | 231 N 3rd Ave, Suite 201, Sandpoint, ID 83864-1418 | |
| Susan M Majeski | Clinical Social Worker | 301 N 1st Ave, Suite 202, Sandpoint, ID 83864-1457 | |
| Find all physicians in zip 83864 | |||
| City | SANDPOINT |
| Zip Code | 83864 |
| Specialty | OPTOMETRY |
| City + Specialty | SANDPOINT + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.