Individual provider Active NPI

Kaitlin Peace, MD

  • Surgery Physician
  • Palmer, AK
National Provider Identifier
1659798049
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
172871 Issued in AK
Practice address
425 E Dahlia Ave Ste J
Palmer, AK 99645-6463
Phone
(907) 746-1520
Fax
(907) 746-1521
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 85060 WI
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 010259555 VA
General Practice Physician 208D00000X 010259555 VA
Surgery Physician 208600000X 172871 AK Primary

Addresses

Primary practice location

425 E Dahlia Ave Ste J
Palmer, AK 99645-6463

Mailing address

PO Box 75032
Chicago, IL 60675-5032
Phone (907) 746-1520

Other practice location 1

2116 Craig Rd
Eau Claire, WI 54701-6118
Phone (715) 858-4610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210414002150 TX Practitioner - General Surgery 2567881147 Reassigns benefits to 1 organization
I20240408000305 AK Practitioner - General Surgery 2567881147 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacier Surgical Associates IncGroup PAC ID 2163641630, 3 clinicians

Practice addresses (Care Compare)

425 E Dahlia Ave
Suite J
Palmer, AK 99645-6463
Phone (907) 746-1520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux20
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
172871AKMDSurgery Physician
85060WIMDSurgery Physician
010259555VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Nov 26, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Dec 28, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Nov 26, 2024 Accepting new patients
Glacier Surgical Associates, Inc Single Specialty CurrentSince Apr 1, 2025 Accepting new patients
South Peninsula Hospital, Inc. Single Specialty CurrentSince Jan 13, 2024 Accepting new patients
Memorial Hospital Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Nov 26, 2024 Accepting new patients
MCHS Hospitals Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Flambeau Hospital Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Lakeview Medical Center Inc of Rice Lake Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Alaska Native Tribal Health Consortium Single Specialty CurrentSince Apr 8, 2021 Accepting new patients
MCHS Hospitals Inc Single Specialty Current Accepting new patients
MCHS Hospitals Inc Single Specialty Current Accepting new patients
Flambeau Hospital Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
Marshfield Clinic Inc Single Specialty CurrentSince Nov 26, 2024 Accepting new patients
South Peninsula Hospital, Inc CurrentSince Dec 28, 2023 Accepting new patients
Alaska Native Tribal Health Consortium Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

425 E Dahlia Ave
Ste J
Palmer, AK 99645
Phone (907) 745-8379

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

2116 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sphosp-0c203fcf
  • Direct secure messaging: kaitlin.peace.1@14977.direct.athenahealth.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 1

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1659798049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75032",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606755032",
            "telephone_number": "907-746-1520",
            "fax_number": "907-746-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E DAHLIA AVE STE J",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456463",
            "telephone_number": "907-746-1520",
            "fax_number": "907-746-1521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016118",
            "country_code": "US",
            "telephone_number": "715-858-4610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACE",
        "first_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "85060",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "VA",
            "license": "010259555",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "010259555",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "172871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

Verify at the official NPI Registry.