Kevin P Peterson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27012 Issued in MN

Practice address

1414 Maryland Ave E
Umphysicians Phalen Village Clinic
Minneapolis, MN 55106

Phone

(651) 772-3461

Fax

(651) 772-5477

NPI assigned

Apr 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Family Practice

Education

University of Minnesota Medical School, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213

Merit-based Incentive Payment System (MIPS)

Final score

92.68 of 100Reported as group

Quality

89.73

Promoting interoperability

100

Improvement activities

40

Cost

80.99

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpeterson630806@fairview.direct-ci.com

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.

• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment Care Compare group NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  • Hospitalist Physician
  • Burnsville, MN
  • NPI 1952499444
  NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Healtheast Medical Research Institute

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1720248966
  NPD
• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  NPD (past)
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  NPD (past)

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

• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Care Compare affiliation

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1558327064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE, STE 200",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-884-0649",
            "fax_number": "612-676-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MARYLAND AVE E",
            "address_2": "UMPHYSICIANS PHALEN VILLAGE CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55106",
            "telephone_number": "651-772-3461",
            "fax_number": "651-772-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KEVIN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karolina Peterson, M.D.
• Katherine Peterson, D.O.
• Katie N Peterson, RN
• Kevin Peterson
• Kevin A Peterson, MD
• Linda Jane Peterson, CRNA
• Linda Marie Peterson
• Lindsey Peterson, OT
• Louise Ballam Peterson
• Marie Elizabeth Peterson, M.D.

• Family Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.