MR. SCOTT D. PETERSEN (PA-C) – Physician Assistant, NPI 1689640948

MR. SCOTT D. PETERSEN (PA-C) is a healthcare provider. based in Avon, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 50.002138 (OH). The NPI Number for MR. SCOTT D. PETERSEN (PA-C) is 1689640948

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
MR. SCOTT D. PETERSEN (PA-C)
NPI
1689640948
Phone
(440) 695-5449
Address
33300 CLEVELAND CLINIC BLVD
Enumeration Date
27 February 2006
Last Update Date
17 November 2016

Doctor Profile

Medical School Name
GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4406955000
Graduation Year
1994 (32 years ago)
PAC ID
6800799057
Group Practice PAC ID
0547552630
Professional Enrollment ID
I20060905000311
Address ID
OH440111172AV33300BLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:20State licenses:3Digital endpointsOther names

5,032 PHYSICIAN ASSISTANT in OH

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Provider Addresses for MR. SCOTT D. PETERSEN (PA-C)

  • Cleveland Clinic Boulevard, Avon, Lorain County, Ohio, 44012, United States

    MAIL CODE AVH4-143

    AVON, OH 44011

    Phone: (440) 695-5449

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-09-05

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
I20060905000311IPhysician AssistantOHTBD

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
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes12765$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes5349$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes3836$0
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes3130$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes2525$0
View full utilization report →

Insurance plans in this area (ZIP 44011)

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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: 0547552630View full group profile
NameSpecialtyState
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
Physician AssistantOH
Nurse PractitionerOH
Physician AssistantOH
Physician AssistantOH
-OH
Physician AssistantOH

Reviews

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Frequently asked questions

Is there an official ID for MR. SCOTT D. PETERSEN (PA-C) in U.S. healthcare records?
The official identifier for MR. SCOTT D. PETERSEN (PA-C) is NPI 1689640948.
Would MR. SCOTT D. PETERSEN (PA-C) appear as active to a payer?
You can treat MR. SCOTT D. PETERSEN (PA-C) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is MR. SCOTT D. PETERSEN (PA-C)?
MR. SCOTT D. PETERSEN (PA-C) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
Where in Ohio is MR. SCOTT D. PETERSEN (PA-C) registered?
Use Avon, Ohio as the headline location for MR. SCOTT D. PETERSEN (PA-C) here.
What does 2 location(s) imply?
2 practice locations appear in the available data.