Jedidiah Allen Petersen, PA
NPI 1366870206ActiveIndividual· Physician Assistant· Polson, MT
Physician Assistant (PA) with Providence St Joseph Medical Center, practicing in Polson, Montana. Part D covered 3,696 prescriptions written in 2024, 89% of them generic. Lists Providence St Joseph Medical Center and 1 other hospital as hospital affiliations.
Overview
| NPI | 1366870206 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | Oct 30, 2013 |
| Last updated in NPPES | Dec 8, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA-1110 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MT) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 3,696 · 6,620 30-day fills |
|---|---|
| Patients | 305 |
| Total drug cost | $222,310 |
| Generic share | 89% of claims |
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Providence St Joseph Medical CenterPolson, MT · 53 clinicians
Hospital affiliations
- Providence St Joseph Medical CenterPolson, MT
- St. Patrick HospitalMissoula, MT
Other facilities
- Partners in Home Care IncHome health agency · Missoula, MT
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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