Doctor profile · Federal record
Dr. Derek Petersen, PA-C
Physician Assistant · Ogden, UT
- NPI 1104365113
- 9 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
2240 Adams Ave
Ogden, UT 844011511
(801) 393-5355 - Additional location
-
5285 S 400 E Ste A
Washington Terrace, UT 844057194
(801) 334-0048
fax (833) 428-8406
Credentials & registration
- NPI registered
- February 2017 — 9 yrs on file
- Profile last updated
- February 3, 2026
- Specialty taxonomy
- 363A00000X — NUCC code
- State license (1)
- Utah #10232646-1206
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1104365113. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$15
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Verrica Pharmaceuticals Inc. | 1 | $14.89 |
By nature of payment
Frequently asked questions
What is Dr. Derek Petersen's medical specialty?
Dr. Derek Petersen practices Physician Assistant in Ogden, UT.
Where does Dr. Derek Petersen practice?
Dr. Derek Petersen practices at 2240 Adams Ave, Ogden, UT 844011511. Office phone: 8013935355.
What is Dr. Derek Petersen's NPI?
Dr. Derek Petersen's National Provider Identifier (NPI) is 1104365113, issued by NPPES.