JESSIE L PETERSON (PT, DPT, LAT, ATC) – Physical Therapist, NPI 1194462481

JESSIE L PETERSON (PT, DPT, LAT, ATC) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT, LAT, ATC. The NPI Number for JESSIE L PETERSON (PT, DPT, LAT, ATC) is 1194462481

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
JESSIE L PETERSON (PT, DPT, LAT, ATC)
NPI
1194462481
Phone
(702) 468-1266
Address
5271 MINERAL LAKE DR
Enumeration Date
18 May 2022
Last Update Date
7 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7026602694
Graduation Year
2022 (4 years ago)
PAC ID
3375924319
Group Practice PAC ID
1951453075
Professional Enrollment ID
I20220721001916
Address ID
NV891298932LA9050XAVEX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:4State licenses:0Digital endpointsOther names

880 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NV

Provider Addresses for JESSIE L PETERSON (PT, DPT, LAT, ATC)

  • 5271 MINERAL LAKE DR

    LAS VEGAS, NV 891228345

    Phone: (702) 468-1266

    Type: Mailing

  • 7351 PRAIRIE FALCON RD STE 100

    LAS VEGAS, NV 891280820

    Phone: (702) 968-0520

    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: 2022-07-21

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
I20220721001916IPhysical Therapist In Private PracticeNVTBD

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
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,53762$0
97140Therapy procedure using manual technique, each 15 minutes65949$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care50438$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes49840$0
97150Therapy procedure in a group setting23834$0
View full utilization report →

Insurance plans in this area (ZIP 89122)

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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: 1951453075View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeSC
Physical Therapist In Private PracticeNV
-NV
Physical Therapist In Private PracticeNV
-NV
-IL
Physical Therapist In Private PracticeNV

Reviews

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Frequently asked questions

What is the standard ID for JESSIE L PETERSON (PT, DPT, LAT, ATC) in the U.S.?
In the U.S., JESSIE L PETERSON (PT, DPT, LAT, ATC) is identified by NPI 1194462481.
Quick check: is JESSIE L PETERSON (PT, DPT, LAT, ATC) active?
Public NPPES data shows JESSIE L PETERSON (PT, DPT, LAT, ATC) with an active NPI status right now.
What services align with JESSIE L PETERSON (PT, DPT, LAT, ATC)'s listing?
JESSIE L PETERSON (PT, DPT, LAT, ATC)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
Is JESSIE L PETERSON (PT, DPT, LAT, ATC) tied to Las Vegas, Nevada?
If you are local to Las Vegas, Nevada, JESSIE L PETERSON (PT, DPT, LAT, ATC) may be relevant to your search.
Can I export JESSIE L PETERSON (PT, DPT, LAT, ATC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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