Kendall K Peters, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME100894 Issued in FL

Practice address

801 N Orange Ave Ste 815
Orlando, FL 32801-5203

Phone

(407) 898-1436

Fax

(407) 898-6330

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Plastic and Reconstructive SurgeryAlso: Maxillofacial Surgery

Education

University of Florida College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susie@petersplasticsurgery.providersdirect.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.

• Center for Plastic & Reconstructive Surgery a Professional Association

  • Plastic and Reconstructive Surgery Physician
  • Orlando, FL
  • NPI 1902844038
  Medicare reassignment NPD

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

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1710926548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE",
            "address_2": "SUITE 442",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-898-1436",
            "fax_number": "407-898-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N ORANGE AVE STE 815",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328015203",
            "telephone_number": "407-898-1436",
            "fax_number": "407-898-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "KENDALL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME100894",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "056206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32038",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "789853741",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Lynette Peters, APRN
• Bruce Wilberforce Peters Jr.
• Calvin Ronald Peters, MD
• Chelsea Monique Peters, DNP, APRN, CPNP-PC
• Jessica Peters
• Kevin Michael Peters
• Krysta Peters, M.D.
• Lisa M Peters, DMD
• Christian Petersen-Hays, DPT
• Eric Petersen

• Plastic Surgery Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.