DR. JAYNE MARIE PETERSON (M.D.) – Internal Medicine Physician, NPI 1124084397

DR. JAYNE MARIE PETERSON (M.D.) is a healthcare provider. based in Phoenix, Arizona. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. 18828 (AZ). The NPI Number for DR. JAYNE MARIE PETERSON (M.D.) is 1124084397

Main info

Female
Sole Proprietor
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAYNE MARIE PETERSON (M.D.)
NPI
1124084397
Phone
(602) 839-3927
Address
1300 N 12TH STREET
Enumeration Date
25 April 2006
Last Update Date
19 May 2011

Doctor Profile

Medical School Name
UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Secondary Phone
6028393927
Graduation Year
1985 (41 years ago)
PAC ID
4880768910
Group Practice PAC ID
2365746450
Professional Enrollment ID
I20080807000075
Address ID
AZ850062849PH1300XSTXX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,585 INTERNAL MEDICINE in AZ

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Provider Addresses for DR. JAYNE MARIE PETERSON (M.D.)

  • Edwards Medical Plaza, 1300, North 12th Street, North Garfield, Central City, Phoenix, Maricopa County, Arizona, 85006, United States

    SUITE 508

    PHOENIX, AZ 850062849

    Phone: (602) 839-3927

    Fax: (602) 839-4233

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $55.

Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.

Last reported payment date: 2024-03-05 • Largest payer in this snapshot: Exact Sciences Corporation ($36).

Total Amount

$55

General + Research + Ownership

Payments

3

Total payment records

General Amount

$55

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-08-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080807000075IInternal MedicineAZTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes12280$0
99213Established patient office or other outpatient visit, 20-29 minutes3232$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1919$0
View full utilization report →

Insurance plans in this area (ZIP 85006)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365746450View full group profile
NameSpecialtyState
Internal MedicineAZ
Family PracticeAZ
Family PracticeAZ
Internal MedicineNY
Family PracticeAZ
Internal MedicineAZ
Physician AssistantAZ
-AZ
Family PracticeAZ
Family Practice, HospitalistAZ

Reviews

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Frequently asked questions

What NPI should I save for DR. JAYNE MARIE PETERSON (M.D.)?
Save NPI 1124084397 if you need a stable reference for DR. JAYNE MARIE PETERSON (M.D.).
Is DR. JAYNE MARIE PETERSON (M.D.) currently active in the NPI registry?
CMS-published data lists DR. JAYNE MARIE PETERSON (M.D.) as an active registrant.
What does DR. JAYNE MARIE PETERSON (M.D.) treat or focus on?
Patients typically see DR. JAYNE MARIE PETERSON (M.D.) under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. JAYNE MARIE PETERSON (M.D.) practice in Arizona?
You will see Phoenix, Arizona on file for DR. JAYNE MARIE PETERSON (M.D.) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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