Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1568920080 Individual Practitioner Male Practitioner

Wiley D Petersen , PA-C

Physician Assistant • Chubbuck, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Wiley Petersen, PA-C is a certified Physician Assistant practicing in Chubbuck, ID. With approximately 8 years of clinical experience since completing medical education in 2018, Wiley Petersen delivers high-quality medical care to the local community at 134 W CHUBBUCK RD.

Wiley Petersen is affiliated with Mvh Pic Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include insertion of needle into vein for collection of blood sample, established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

134 W Chubbuck Rd

Chubbuck, ID 832022338

Telephone 2084170102
Fax 2082423219
Associated Practice Facility / Clinic
🏢 Finn Chiropractic,pllc Facility NPI 1669642302

Medicare Profile & Education

Medical School

Other

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Chubbuck, ID

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs -5.3 yrs vs City Avg
City Avg: 13.3 Yrs
State Avg: 12.4 Yrs
Regional Practice Density
9 Specialists

Practicing in Chubbuck, ID (1261 Statewide)

Telehealth Adoption Rate
22.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
54.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Petersen (8 Years) 8 Yrs
Chubbuck Specialty Average (13.3 Years) 13.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample
75 51 $15.00 $8.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
56 40 $261.38 $100.45
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
41 41 $130.00 $96.65
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count
39 34 $30.00 $7.38
99213 Established patient office or other outpatient visit, typically 15 minutes
24 21 $181.88 $69.46
83036 Hemoglobin A1C level
19 17 $25.00 $9.28

Medical Specialties & State Licenses

CMS Verified: 2024-05-17
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License ID PA-1714

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Mvh Pic Llc

495 Yellowstone Ave, Pocatello, ID 832014531

Phone: 2084787422

Mvh Pic Llc

134 W Chubbuck Rd, Chubbuck, ID 832022383

Phone: 2082377911

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1023966850

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location May 17, 2024

Registered at 134 W CHUBBUCK RD, CHUBBUCK, ID 832022338 (Tel: 2084170102)

📍
Updated Business Mailing Address May 17, 2024

Registered at 5014 MARY LN, POCATELLO, ID 832021679 (Tel: 2082415819)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 17, 2024

Physician Assistant (License #PA-1714 in ID)

NPI Profile Active March 04, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location March 04, 2019

Registered at 717 MISSION RD, FORT HALL, ID 83203 (Tel: 2082385435)

📍
Updated Business Mailing Address March 04, 2019

Registered at PO BOX 306, FORT HALL, ID 832030306 (Tel: 2082385435)

👤
Provider Name / Credentials Updated March 04, 2019

Recorded as WILEY PETERSEN, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 04, 2019

Family Medicine (License #PA-1714 in ID)

🟢
Initial NPI Registration & Enumeration March 04, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Wiley Petersen. Be the first to share your experience!

Sign in to leave a review for Wiley Petersen

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1568920080
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 04, 2019
Last Update: May 17, 2024
Sole Proprietor: Yes

Mailing Address

5014 Mary Ln

Pocatello, ID 832021679

Phone: 2082415819

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.