SHARON ROSE PETERSON (MD) – Family Medicine Physician, NPI 1336304138

SHARON ROSE PETERSON (MD) is a healthcare provider. based in Burns, Oregon. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. MD153463 (OR). The NPI Number for SHARON ROSE PETERSON (MD) is 1336304138

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
SHARON ROSE PETERSON (MD)
NPI
1336304138
Phone
(541) 573-2074
Address
559 W Washington St
Enumeration Date
22 July 2008
Last Update Date
14 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2008 (18 years ago)
PAC ID
1658541172
Group Practice PAC ID
5496141004
Professional Enrollment ID
I20220919002716
Address ID
OR977201544Bu77XXXSTXX400
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

2,081 FAMILY PRACTICE in OR

Provider Addresses for SHARON ROSE PETERSON (MD)

  • 559 W Washington St

    Burns, OR 977201441

    Phone: (541) 573-2074

    Fax: (541) 573-8893

    Type: Location

  • Southwest Murray Scholls Place, Murray Scholls Town Center, Neighbors Southwest, Beaverton, Metro, Washington County, Oregon, 97007, United States

    BEAVERTON, OR 970079816

    Phone: (503) 813-3860

    Type: Mailing

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: 2022-09-19

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
I20110818000829IFamily PracticeORTBD
I20220919002716IFamily 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.

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

Insurance plans in this area (ZIP 97720)

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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: 5496141004View full group profile
NameSpecialtyState
Physician AssistantOR

Reviews

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Frequently asked questions

What unique ID ties claims to SHARON ROSE PETERSON (MD)?
NPI 1336304138 is assigned to SHARON ROSE PETERSON (MD) under the national enumeration system.
Is SHARON ROSE PETERSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does SHARON ROSE PETERSON (MD) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for SHARON ROSE PETERSON (MD). Clinical services aligned with this taxonomy classification.
What location shows for SHARON ROSE PETERSON (MD)?
We surface Burns, Oregon for SHARON ROSE PETERSON (MD) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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