Doctor profile · Federal record

Dr. Wiley Petersen, PA-C

Physician Assistant · Chubbuck, ID

  • NPI 1568920080
  • Accepts Medicare
  • 8 yrs in practice
  • Male
  • Solo practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
134 W Chubbuck RD
Chubbuck, ID 832022338
(208) 417-0102
fax (208) 242-3219
Mailing address
5014 Mary Ln
Pocatello, ID 832021679

Credentials & registration

NPPES · NUCC
NPI registered
March 2019 — 7 yrs on file
Profile last updated
May 17, 2024
Year of graduation
2018 — 8 yrs since
Specialty taxonomy
363A00000X — NUCC code
State license (1)
Idaho #PA-1714

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1568920080. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
321
Distinct HCPCS
7
Medicare allowed
$18,057
HCPCS Description Services Patients Avg allowed
36415 Insertion of needle into vein for collection of blood sample 81 54 $8
99213 Established patient office or other outpatient visit, 20-29 minutes 74 66 $71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 45 45 $101
99214 Established patient office or other outpatient visit, 30-39 minutes 44 39 $98
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 40 32 $8
99215 Established patient office or other outpatient visit, 40-54 minutes 20 16 $140
83036 Hemoglobin a1c level 17 15 $10

In context: peer comparison

Among 3 peers in Chubbuck Physician Assistant, average services per provider: 673. This provider delivers 0.5× the peer median.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$218
Transactions
10
Manufacturers
5
Payer (manufacturer) Industry Txns Amount
Abbvie INC. 5 $132.14
Axsome Therapeutics, INC. 2 $30.08
Corcept Therapeutics 1 $24.33
GlaxoSmithKline, LLC. 1 $18.13
Lilly USA, LLC 1 $13.77

By nature of payment

Food and Beverage
$218

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
517
Patients
154
Total drug cost
$6,586
Drug Type Claims Patients Total cost
Levothyroxine Sodium Generic 78 38 $1,234
Lisinopril Generic 53 21 $422
Losartan Potassium Generic 47 21 $627
Metformin Hcl Generic 40 15 $188
Amlodipine Besylate Generic 39 14 $226
Atorvastatin Calcium Generic 37 15 $571
Omeprazole Generic 37 18 $681
Gabapentin Generic 29 12 $495
Lorazepam Generic 25 0 $73
Trazodone Hcl Generic 24 0 $142

Hospital affiliations

CMS Hospital Compare

Frequently asked questions

Auto-generated from federal data
What is Dr. Wiley Petersen's medical specialty?
Dr. Wiley Petersen practices Physician Assistant in Chubbuck, ID.
Where does Dr. Wiley Petersen practice?
Dr. Wiley Petersen practices at 134 W Chubbuck RD, Chubbuck, ID 832022338. Office phone: 2084170102.
What is Dr. Wiley Petersen's NPI?
Dr. Wiley Petersen's National Provider Identifier (NPI) is 1568920080, issued by NPPES.
Does Dr. Wiley Petersen accept Medicare assignment?
Yes. Dr. Wiley Petersen accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Wiley Petersen commonly perform?
Top Medicare-reported procedures in 2023: Insertion of needle into vein for collection of blood sample (HCPCS 36415); Established patient office or other outpatient visit (HCPCS 99213); Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS G0439). Source: CMS Medicare Physician & Other Practitioners file.