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

Owen Petersen, PA

Individual provider Athletic Trainer · NPI 1457896300

Owen Petersen, PA is a Physician Assistant in Albany, New York. Qualified in 2021, 5 years ago. Practices with Cora Health Services Inc, a 1,144-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2017
Specialties on file
4
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

121 Everett Rd
Albany, NY 12205-1474
Phone: (518) 489-2663
Fax: (518) 689-3881
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 027272 (NY)
Athletic Trainer Taxonomy 2255A2300X
Physician Assistant Taxonomy 363A00000X · Licence 027272 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1457896300
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 2, 2017
Last updated in NPPESJuly 16, 2025
Certification dateJuly 16, 2025
Mailing address121 Everett Rd, Albany, NY 12205-1474

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Cora Health Services Inc — 1144 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Albany