Abigail Kiesow, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME177661 Issued in FL

Practice address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Phone

(850) 883-8600

NPI assigned

Feb 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Abigail Petersen Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Destin Anesthesia, LLCGroup PAC ID 9830158500, 20 clinicians

Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012
  Medicare reassignment Care Compare group NPD
• Destin Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Destin, FL
  • NPI 1891726394

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Fleming Island Anesthesia LLC

  • Anesthesiology Physician
  • Orange Park, FL
  • NPI 1487945895
  Medicare reassignment NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Gainesville, FL
  • NPI 1164932901
  Medicare reassignment
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Panama City, FL
  • NPI 1487160263
  NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Kissimmee, FL
  • NPI 1902478431
  NPD

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771718400000",
    "number": "1295329159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Mar Walt Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325476708",
            "country_code": "US",
            "telephone_number": "850-862-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIESOW",
        "first_name": "ABIGAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME177661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "PETERSEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Walter Keilbarth, DO
• Courtney Kelly, DMD
• Kestraunda Kelly, FNP
• Ngoc Kelsch, DENTAL HYGIENIST
• Andrea G. Kern, RDH
• Caleb Kiesow, MD
• Dereje A Kifle
• Jonah R Kincaid
• Scott Alexander King, M.D.
• Jamie Lynn Krassow, MD

• Anesthesiology Physician in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.