JEFFREY ROBERT PETRA PH.D.
NPI 1487739603
Psychologist - Clinical Child & Adolescent in Olympia, WA
NPI Status: Active since October 26, 2006
Contact Information
1800 COOPER POINT RD SW STE 17
OLYMPIA, WA
ZIP 98502
Phone: (360) 754-4662
Fax: (360) 352-3289
- Individual
- Male
- Years of Experience 26
- Psychologist
- Clinical Child & Adolescent
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About JEFFREY PETRA
This page provides the complete NPI Profile along with additional information for Jeffrey Petra, a provider established in Olympia, Washington with a medical specialization in Psychologist, focusing in clinical child & adolescent and more than 26 years of experience. The healthcare provider is registered in the NPI registry with number 1487739603 assigned on October 2006. The practitioner's primary taxonomy code is 103TC2200X. The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1487739603
- Provider Name
- JEFFREY ROBERT PETRA PH.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502
- Location Phone
- (360) 754-4662
- Location Fax
- (360) 352-3289
- Mailing Address
- PO BOX 11009 OLYMPIA, WA 98508
- Mailing Phone
- (360) 352-2037
- Mailing Fax
- (360) 352-3289
- Medical School Name
- OTHER
- Graduation Year
- 2000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-26-2006
- Last Update Date
- 07-08-2007
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical Child & Adolescent
- Taxonomy Code
- 103TC2200X
- Type
- Behavioral Health & Social Service Providers
- Taxonomy Description
- A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jeffrey Petra is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Jeffrey Petra is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4486875580
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20141014001394
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 8 | 7 | 7 | 3 | 9 | 6 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 16 | 7 | 14 | 3 | 18 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 6 + 7 + 1 + 4 + 3 + 1 + 8 + 6 + 0 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1487739603 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1730369877 | GREGORY L. WILLIAMS, PSY.D., PC Organization | Psychologist (Clinical) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 754-4662 |
| 1811164270 | SCOTT D COLEMAN Individual | Counselor (Mental Health) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 352-1668 |
| 1932238268 | MS. CHERYL ANN DEVINY LMHC Individual | Counselor (Mental Health) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 280-2015 |
| 1205230794 | JOHN SHATTUCK LMHC Individual | Counselor (Mental Health) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 915-3887 |
| 1568589406 | KELLEY SIMMONS JONES LMHC Individual | Counselor (Mental Health) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 970-2135 |
| 1639067580 | BELIEF CENTER FOR FAMILY THERAPY Organization | Clinic/Center (Mental Health (Including Community Mental Health Center)) | 1800 COOPER POINT RD SW STE 17 OLYMPIA, WA 98502 (360) 451-3405 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487739603, enumerated in the NPI registry as an "individual" on October 26, 2006
The provider is located at 1800 Cooper Point Rd Sw Ste 17 Olympia, Wa 98502 and the phone number is (360) 754-4662
The provider's speciality is Psychologist with taxonomy code 103TC2200X with a focus in Clinical Child & Adolescent
The provider has more than 26 years of experience.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
This NPI record was last updated on October 26, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.