DR. JED RUSSELL PETERSON (M.D.) – Vascular & Interventional Radiology Physician, NPI 1164634770
Vascular & Interventional Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
85 INTERVENTIONAL RADIOLOGY in OR
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Provider Addresses for DR. JED RUSSELL PETERSON (M.D.)
Adventist Medical Center, 10123, Southeast Market Street, Hazelwood, Portland, Metro, Multnomah County, Oregon, 97216, United States
DEPARTMENT OF RADIOLOGY
PORTLAND, OR 972162532
Phone: (503) 251-6137
Fax: (503) 261-6058
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)
CMS reports 106 Open Payments records for all available years, with a total value of $5,643.
Total Amount is formed as General ($5,643) + Research ($0) + Ownership ($0) = $5,643.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Inari Medical, Inc. ($1,539).
Total Amount
$5,643
General + Research + Ownership
Payments
106
Total payment records
General Amount
$5,643
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $1,539 |
| Sirtex Medical Inc | $1,223 |
| Penumbra, Inc. | $874 |
| Cook Medical LLC | $495 |
| Medtronic, Inc. | $479 |
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: 2012-06-22
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 |
|---|---|---|---|---|
| I20120622000541 | I | Diagnostic Radiology | OR | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 177 | 156 | $0 |
| 71046 | X-ray of chest, 2 views | 81 | 80 | $0 |
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 47 | 46 | $0 |
| 73502 | X-ray of hip, 2-3 views | 45 | 42 | $0 |
| 73564 | X-ray of knee, 4 or more views | 42 | 24 | $0 |
Insurance plans in this area (ZIP 97216)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | OR | 71010 | X-ray of chest, 1 view, front | 260 | 212 |
| DIAGNOSTIC RADIOLOGY | OR | 73562 | X-ray of knee, 3 views | 18 | 15 |
| DIAGNOSTIC RADIOLOGY | OR | 76830 | Ultrasound pelvis through vagina | 13 | 13 |
| DIAGNOSTIC RADIOLOGY | OR | 78815 | Nuclear medicine study with CT imaging skull base to mid-thigh | 12 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| - | OR | |
| Interventional Radiology, Diagnostic Radiology | OR | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | VA | |
| Interventional Radiology, Diagnostic Radiology, Diagnostic Radiology, Interventional Radiology | OR | |
| Diagnostic Radiology | CT | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | OR | |
| Diagnostic Radiology | MO |
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