DR. RYAN CARL PETERING (MD) – Sports Medicine (Family Medicine) Physician, NPI 1174793301

DR. RYAN CARL PETERING (MD) is a healthcare provider. based in Portland, Oregon. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. MD29263 (OR). The NPI Number for DR. RYAN CARL PETERING (MD) is 1174793301

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. RYAN CARL PETERING (MD)
NPI
1174793301
Phone
(503) 494-9992
Address
3181 SW SAM JACKSON PARK RD
Enumeration Date
4 March 2008
Last Update Date
3 September 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5034949992
Graduation Year
2006 (20 years ago)
PAC ID
5890840458
Group Practice PAC ID
4880760107
Professional Enrollment ID
I20090902000660
Address ID
OR972191020PO4411XSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

2,081 FAMILY PRACTICE in OR

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Provider Addresses for DR. RYAN CARL PETERING (MD)

  • Richard T. Jones Hall, 3181, Southwest Sam Jackson Park Road, Marquam Hill, Homestead, Portland, Metro, Multnomah County, Oregon, 97239, United States

    PORTLAND, OR 972393011

    Phone: (503) 494-9992

    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: 2025-06-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20090902000660IFamily PracticeORTBD
I20250626003912IFamily PracticeWATBD

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
99214Established patient office or other outpatient visit, 30-39 minutes14087$0
20610Aspiration and/or injection of fluid from large joint4727$0
99213Established patient office or other outpatient visit, 20-29 minutes4642$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes4613$0
20611Aspiration and/or injection of fluid large joint using ultrasound guidance4534$0
View full utilization report →

Insurance plans in this area (ZIP 97239)

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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: 4880760107View full group profile

Reviews

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Frequently asked questions

Is DR. RYAN CARL PETERING (MD) listed with a National Provider Identifier?
Yes — DR. RYAN CARL PETERING (MD) has NPI 1174793301 on file in the registry.
Is there an active status for DR. RYAN CARL PETERING (MD)?
For scheduling context, DR. RYAN CARL PETERING (MD) is shown as active in the registry.
What clinical focus is listed for DR. RYAN CARL PETERING (MD)?
At a glance, DR. RYAN CARL PETERING (MD) is tied to Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is DR. RYAN CARL PETERING (MD) associated with Portland?
Public fields place DR. RYAN CARL PETERING (MD) around Portland, Oregon. Always confirm the exact site before visiting.
Can I trust this NPI listing for DR. RYAN CARL PETERING (MD)?
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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