Kevin Peterson, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

S0534 Issued in TX

Practice address

3551 Rodger Brooke Dr
Jbsa-Fort Sam Houston, TX 78234-4504

Phone

(210) 916-8666

Fax

(210) 916-8712

NPI assigned

Feb 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

University of North Texas HSC, College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lone Star Anesthesia Partners PLLCGroup PAC ID 4880072636, 58 clinicians

Austin Anesthesiology Group PLLCGroup PAC ID 0547256497, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpeterson791504@direct.sw.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.

• Austin Anesthesiology Group, PLLC

  • Anesthesiology Physician
  • Austin, TX
  • NPI 1598724304
  Medicare reassignment Care Compare group NPD
• Lone Star Anesthesia Partners PLLC

  • Anesthesiology Physician
  • San Antonio, TX
  • NPI 1124760996
  Medicare reassignment Care Compare group NPD
• Austin Anesthesiology Group PLLC

  • Anesthesiology Physician
  • Bryan, TX
  • NPI 1528326154
  NPD

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

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1124074273
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1689627655
  Care Compare affiliation
• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1952348021
  Care Compare affiliation

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1790225662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 RODGER BROOKE DR",
            "address_2": "ANESTHESIA RESIDENCY",
            "city": "JBSA-FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 RODGER BROOKE DR",
            "city": "JBSA-FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-8666",
            "fax_number": "210-916-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-27",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "S0534",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "S0534",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "S0534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurita Old Hudec, DNP APRN WHNP-BC
• Benjamin Daniel Owen, DMD
• James Oyetunde Oyekan, MD
• William Parkinson, MD
• Shane Burr Patterson, M.D.
• Tiffany N Pitre, DPT, PT
• Rachel Elizabeth Powers, MD
• Mackenzie Reed Joyce Prendergast, DO
• Ian Prichard, DO, RDCS
• Emily Raetz

• Pain Medicine (Anesthesiology) Physician in Jbsa-Fort Sam Houston, TX
• Providers in Jbsa-Fort Sam Houston, TX by specialty
• Pain Medicine (Anesthesiology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.