Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Michael Petersen, MD

Individual provider Emergency Medicine Physician · NPI 1952989816

Jordan Michael Petersen, MD is an Emergency Medicine in Portland, Oregon. Graduated from Harvard Medical School in 2021, 5 years ago. Practices with Providence Health and Services - Oregon, a 218-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Trained at
Harvard Medical School
Licensed in
OR
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone: (503) 216-1234
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence MD223168 (OR)

Record details

NPI number1952989816
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2021
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 2021 (5 years in practice)
Group practice Providence Health And Services - Oregon — 218 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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