Michael Jake Petersen, MD
NPI 1780248146ActiveIndividual· Pediatrics, Sports Medicine· Seattle, WA
Pediatrics, Sports Medicine (MD) in Seattle, Washington, trained at Rush Medical College of Rush University (class of 2021). Enrolled in Medicare as practitioner - sports medicine.
Overview
| NPI | 1780248146 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | Apr 30, 2019 |
| Last updated in NPPES | Apr 11, 2026 |
| Certified by provider | Apr 11, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics, Sports Medicine Primary | 2080S0010X | MD.MD.61679347 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Sports Medicine (WA) |
|---|
Education and affiliations
| Medical school | Rush Medical College of Rush University |
|---|---|
| Graduation year | 2021 |
| Medicare specialty | Sports Medicine |
| Secondary specialties | Pediatric Medicine |
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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