NPIMap

Individual provider Active NPI

Kirsten D Peterson, MD

  • Internal Medicine Physician
  • Finley, ND
National Provider Identifier
1285636423
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5959 Issued in ND
Practice address
407 Washington Ave E
Finley, ND 58230-3031
Phone
(701) 524-1005
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37385 WI
Internal Medicine Physician 207R00000X 5959 ND Primary

Addresses

Primary practice location

407 Washington Ave E
Finley, ND 58230-3031

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpeterson17217634@direct.sanfordhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070327000419 ND Practitioner - Internal Medicine 6406950757 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Dakota School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

618 14TH Ave NE
Devils Lake, ND 58301-2808
Phone (701) 544-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Internal Medicine CurrentSince Jul 29, 2022 Accepting new patients
Kidney and Hypertension PLC CurrentSince Apr 5, 2019 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 29, 2022 Accepting new patients
Sanford Health Network North CurrentSince Jun 9, 2021 Accepting new patients
Sanford Health Network North Internal Medicine CurrentSince Jun 9, 2021 Accepting new patients
Sanford Clinic North Internal Medicine Past Accepting new patients

Locations

4474 23rd Ave S
Ste M
Fargo, ND 58104
Phone (701) 281-3900

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

407 Washington Ave E
Finley, ND 58230
Phone (701) 524-1005

5750 S Washington St
Grand Forks, ND 58201
Phone (701) 732-2819

1750 47th Ave S
Grand Forks, ND 58201
Phone (701) 757-8700

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 6

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1285636423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 WASHINGTON AVE E",
            "city": "FINLEY",
            "state": "ND",
            "postal_code": "582303031",
            "telephone_number": "701-524-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KIRSTEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "37385",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "5959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeterson17217634@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "407 Washington Ave E",
            "city": "Finley",
            "state": "ND",
            "country_code": "US",
            "postal_code": "582303031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Finley, ND

Sources for this page

Verify at the official NPI Registry.