MS. PATRICIA JEAN PETERSEN (LISW) – Clinical Social Worker, NPI 1356343834

MS. PATRICIA JEAN PETERSEN (LISW) is a healthcare provider. based in Johnston, Iowa. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. 05924 (IA). The NPI Number for MS. PATRICIA JEAN PETERSEN (LISW) is 1356343834

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
MS. PATRICIA JEAN PETERSEN (LISW)
NPI
1356343834
Phone
(515) 251-4914
Address
8859 NW 67TH CT
Enumeration Date
15 August 2005
Deactivation Date
22 March 2006
Reactivation Date
28 March 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5152019953
Graduation Year
2000 (26 years ago)
PAC ID
9830435569
Professional Enrollment ID
I20190116002992
Address ID
IA503113310DE1104XSTXX300
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

827 CLINICAL SOCIAL WORKER in IA

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Provider Addresses for MS. PATRICIA JEAN PETERSEN (LISW)

  • 8859 NW 67TH CT

    JOHNSTON, IA 501311900

    Phone: (515) 251-4914

    Type: Mailing

  • 5525, Meredith Drive, Meredith Village, Des Moines, Polk County, Iowa, 50310, United States

    DES MOINES, IA 503102334

    Phone: (515) 251-4914

    Type: Location

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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-16

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
I20190116002992IClinical Social WorkerIATBD

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.

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

Insurance plans in this area (ZIP 50131)

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Reviews

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Frequently asked questions

Can I cross-check MS. PATRICIA JEAN PETERSEN (LISW) using NPI 1356343834?
NPI 1356343834 belongs to MS. PATRICIA JEAN PETERSEN (LISW); compare other details if you need extra assurance.
Would MS. PATRICIA JEAN PETERSEN (LISW) appear as active to a payer?
You can treat MS. PATRICIA JEAN PETERSEN (LISW) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for MS. PATRICIA JEAN PETERSEN (LISW)?
At a glance, MS. PATRICIA JEAN PETERSEN (LISW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is MS. PATRICIA JEAN PETERSEN (LISW) located near Johnston?
MS. PATRICIA JEAN PETERSEN (LISW) currently maps to Johnston, Iowa in this extract.
Can I trust this NPI listing for MS. PATRICIA JEAN PETERSEN (LISW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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