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

Michael Peterson, PA-C

Individual provider Physician Assistant · NPI 1144885575

Michael Peterson, PA-C is a Physician Assistant in Roseburg, Oregon. Qualified in 2020, 6 years ago. Practices with Centennial Medical Group Inc, a 61-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
6
Licensed in
OR
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2801 NW Mercy Dr Ste 300
Roseburg, OR 97471-2348
Phone: (541) 677-1555
Fax: (541) 677-2294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA197860 (OR)

Record details

NPI number1144885575
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 1, 2019
Last updated in NPPESOctober 1, 2020
Certification dateOctober 1, 2020
Mailing address201 Nw Medical Loop Ste 190, Roseburg, OR 97471-8835

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Centennial Medical Group Inc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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