ELIZABETH JEAN PETERSON (PA) – Physician Assistant, NPI 1316505910
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,649 PHYSICIAN ASSISTANT in IA
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Provider Addresses for ELIZABETH JEAN PETERSON (PA)
3973 QUINCY AVE
WALL LAKE, IA 514667580
Phone: (712) 830-7708
Type: Mailing
1351, West Main Street, Lake City, Calhoun County, Iowa, 51449, United States
LAKE CITY, IA 514491585
Phone: (712) 464-7907
Type: Location
1800 MAIN ST
GOWRIE, IA 505437438
Phone: (515) 352-3891
Type: Location
625 RICHMOND ST
ROCKWELL CITY, IA 505791337
Phone: (712) 830-7708
Type: Mailing
1301 W MAIN ST
LAKE CITY, IA 514491585
Phone: (712) 464-4200
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $469.
Total Amount is formed as General ($469) + Research ($0) + Ownership ($0) = $469.
Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($108).
Total Amount
$469
General + Research + Ownership
Payments
26
Total payment records
General Amount
$469
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Vanda Pharmaceuticals Inc. | $108 |
| Lilly USA, LLC | $61 |
| ABBVIE INC. | $51 |
| Corium, LLC | $49 |
| Novo Nordisk Inc | $41 |
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: 2019-10-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191007002197 | I | Physician Assistant | IA | TBD |
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.
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 51466)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | MO | |
| Emergency Medicine | IA | |
| Nurse Practitioner | IA | |
| Physician Assistant | IA | |
| Clinical Social Worker | IA | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IA | |
| General Surgery | IA | |
| - | IL | |
| Physician Assistant | IA |
Reviews
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