PHILLIP H PETERSEN (MD) – Family Medicine Physician, NPI 1295730661

Family Medicine Physician

PHILLIP H PETERSEN (MD) is a healthcare provider. based in Orofino, Idaho. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. M5405 (ID). The NPI Number for PHILLIP H PETERSEN (MD) is 1295730661

Main info

Male

40 Years Of Experience

Accepts Medicare Assignment

Name

PHILLIP H PETERSEN (MD)

NPI

1295730661

Phone

(208) 476-4555

Address

301 CEDAR ST

Enumeration Date

14 June 2005

Last Update Date

19 December 2017

Doctor Profile

Medical School Name

UNIVERSITY OF UTAH SCHOOL OF MEDICINE

Secondary Phone

2084764555

Graduation Year

1986 (40 years ago)

PAC ID

6305980863

Group Practice PAC ID

0547173346

Professional Enrollment ID

I20100222000421

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

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Provider Addresses for PHILLIP H PETERSEN (MD)

Clearwater Valley Hospital, 301, Cedar Street, Orofino, Clearwater County, Idaho, 83544, United States
OROFINO, ID 835449029
Phone: (208) 476-4555
Fax: (208) 476-5385
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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83544)

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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: 0547173346View full group profile

Name	Specialty	State
ANNA FOX (MD)	Family Practice	ID
JANE A FORE (MD)	Internal Medicine	WA
SIERRA LYNN HOLLAR (DO)	Family Practice	ID
TUCKER JEPPSON (DO)	Diagnostic Radiology	ID
ROBERT M FARNER (MD)	Diagnostic Radiology	ID
DR. BROOKE ELLEN POTRATZ (MD)	Family Practice	ID
CHRISTIN S REISENAUER (MD)	Diagnostic Radiology	ID
DR. PHEBE LORE ALLEY (MD)	Family Practice	MN
VANESSA KIMBERLY BROWN (M.D.)	Family Practice	ID
KARIN SCHMIDOVA (MD)	General Surgery	CO

Reviews

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Frequently asked questions

How do I look up PHILLIP H PETERSEN (MD) by NPI?

Use NPI 1295730661 when you need to reference PHILLIP H PETERSEN (MD) in forms, claims, or directories.

Does this profile mean PHILLIP H PETERSEN (MD) is currently active?

Yes — PHILLIP H PETERSEN (MD) appears active in the national provider directory.

Does PHILLIP H PETERSEN (MD) list a primary specialty?

If you are matching referrals, note Family Medicine Physician for PHILLIP H PETERSEN (MD). Clinical services aligned with this taxonomy classification.

What location shows for PHILLIP H PETERSEN (MD)?

We surface Orofino, Idaho for PHILLIP H PETERSEN (MD) based on available NPPES addresses.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.