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DR. JED RUSSELL PETERSON M.D. NPI 1164634770


NPI Information

NPI: 1164634770
Provider Name: DR. JED RUSSELL PETERSON, M.D.
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
10123 SE MARKET ST
DEPARTMENT OF RADIOLOGY
PORTLAND, OR
ZIP 97216
Phone: (503) 251-6137
Get Directions

DR. Jed Russell Peterson, M.D. is a vascular and interventional radiology radiology in Portland, OR with 18 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. DR. Jed Russell Peterson, M.D. NPI is 1164634770. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduation Year:2006

The provider's business location address is:

10123 SE MARKET ST
DEPARTMENT OF RADIOLOGY
PORTLAND, OR
ZIP 97216-532
Phone: (503) 251-6137
Fax: (503) 261-6058

The NPI 1164634770 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of chest, 1 view (HCPCS:71045)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes (HCPCS:99152)
  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • X-ray of hip with pelvis, 2-3 views (HCPCS:73502)
  • Nuclear medicine study with ct imaging skull base to mid-thigh (HCPCS:78815)
  • Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Radiological supervision and interpretation of ct guidance for needle insertion (HCPCS:77012)
  • Ct scan head or brain (HCPCS:70450)
  • Ultrasound pelvis through vagina (HCPCS:76830)
  • Ultrasound of head and neck (HCPCS:76536)

The enumeration date for this NPI number is 5/4/2007 and was last updated on 10/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyMD.60212410WASHINGTONNo
22085R0204XRadiologyVascular & Interventional RadiologyMD.60212410WASHINGTONNo
32085R0202XRadiologyDiagnostic Radiology157199OREGONNo
42085R0204XRadiologyVascular & Interventional Radiology157199OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1157199OTHEROREGONOREGON MEDICAL BOARD
2MD60212410OTHERWASHINGTONMEDICAL LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.