Kerry Elizabeth Petersen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C08311 Issued in MD

Practice address

4940 Eastern Avenue
Baltimore, MD 21264-1508

Phone

(410) 550-0100

NPI assigned

Oct 20, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Johns Hopkins UniversityGroup PAC ID 4981745098, 711 clinicians

Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Bayview Medical Center Hospital, Baltimore, MD, CCN 210029

Merit-based Incentive Payment System (MIPS)

Final score

83.31 of 100Reported as group

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Cost

70.47

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpetersen882787@direct.hopkinsmedicine.org

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.

• Johns Hopkins University

  • Hospitalist Physician
  • Baltimore, MD
  • NPI 1902332133
  Medicare reassignment Care Compare group NPD
• Johns Hopkins University

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  Medicare reassignment Care Compare group
• Johns Hopkins University

  • Ophthalmology Physician
  • Belcamp, MD
  • NPI 1376342774
  NPD
• Johns Hopkins University

  • Obesity Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1487405205
  NPD
• Johns Hopkins University

  • Neurology Physician
  • MC Lean, VA
  • NPI 1598552226
  NPD

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

• Johns Hopkins Bayview Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1790700904
  Care Compare affiliation
• Johns Hopkins Bayview Medical Center, Inc.

  • Chronic Disease Hospital
  • Baltimore, MD
  • NPI 1336251412
  Care Compare affiliation

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1457950446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212641508",
            "telephone_number": "410-550-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 W Lexington St Ste 5110",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011508",
            "country_code": "US",
            "telephone_number": "410-777-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "KERRY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C08311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "address_1": "620 W Lexington St Ste 5110",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212011508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven G Peters
• Todd Peters, MD
• Carl Evers Petersen, D.O.
• Jaime Petersen
• Julie Petersen, PHD
• Steve Alan Petersen, MD
• Abby Mackenzie Peterson
• Claire Peterson
• Daniel Albin Peterson, M.D.
• Emma Lee Peterson, PH.D

• Physician Assistant in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.