Individual provider Active NPI

Kristine Mika Peterson, R.D.

  • Registered Dietitian
  • Seattle, WA
National Provider Identifier
1023565355
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60720921 Issued in WA
Practice address
1550 N 115TH St
Seattle, WA 98133-8401
Phone
(206) 520-5000
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1033963 AZ
Registered Dietitian 133V00000X DI60720921 WA Primary

Addresses

Primary practice location

1550 N 115TH St
Seattle, WA 98133-8401

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 2

IdentifierTypeStateIssuer
1033963OtherAZCOMMITTEE ON DIETETIC REGISTRATION ID NUMBER
1023565355MedicaidWA

Other names 1

  • Kristine Tamaki Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmpeter@uw.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201228002310 WA Practitioner - Registered Dietitian Or Nutrition Professional 9032407242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

3800 Montlake Blvd NE
Seattle, WA 98195-0007
Phone (206) 598-1534

4060 E Stevens Way
Hall Health Primary Care Ctr
Seattle, WA 98195-4410
Phone (206) 616-2495

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1033963AZMDRegistered Dietitian
DI60720921WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Dec 8, 2020 Accepting new patients

Locations

24360 Van Ry Blvd
Ste 111
Mountlake Terrace, WA 98043
Phone (425) 275-5555

400 N 34th St
Ste 203
Seattle, WA 98103
Phone (206) 545-9300

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

10330 Meridian Ave N
Ste 230
Seattle, WA 98133
Phone (206) 368-6177

1550 N 115th St
Shoreline, WA 98133
Phone (206) 364-0500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1023565355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N 115TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338401",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KRISTINE",
        "middle_name": "MIKA",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1033963",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60720921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMITTEE ON DIETETIC REGISTRATION ID NUMBER",
            "identifier": "1033963",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023565355",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmpeter@uw.edu",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1550 N 115th St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981338401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "TAMAKI",
            "credential": "R.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.