Derek Petersen, PA-C
NPI 1104365113ActiveIndividual· Physician Assistant· Ogden, UT
Physician Assistant (PA-C) in Ogden, Utah, licensed in UT, with an NPI issued in February 2017. Cranial Technologies, Inc reported $18.08 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1104365113 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Feb 23, 2017 |
| Last updated in NPPES | Feb 3, 2026 |
| Certified by provider | Feb 3, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 10232646-1206 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Industry payments (Open Payments)
- 2025$18.08 · 1 payment from 1 company
- 2024$14.89 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Cranial Technologies, Inc | $18.08 | 1 |
What the 2025 payments were for
- Food and Beverage$18.08 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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