Kelsey Rose Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA164169 Issued in OR

Practice address

1315 NW 4TH St Ste a
Redmond, OR 97756-1328

Phone

(541) 548-7761

Fax

(541) 598-3485

NPI assigned

Jan 25, 2013

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

Other identifiers 1

Other names 1

• Ms. Kelsey Rose Young Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelseyyoungpac@osspc.allscriptsdirect.net

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.

• St. Charles Health System, Inc.

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment Care Compare group NPD
• Oregon Surgical Specialists PC

  • Vascular Surgery Physician
  • Medford, OR
  • NPI 1427139732
  Medicare reassignment

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1902144983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 300",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044316",
            "telephone_number": "541-930-8907",
            "fax_number": "541-245-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 NW 4TH ST STE A",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561328",
            "telephone_number": "541-548-7761",
            "fax_number": "541-598-3485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Medical Center Dr",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975044334",
            "country_code": "US",
            "telephone_number": "541-282-6559",
            "fax_number": "541-282-6710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA164169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500670083",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeterson99650@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "1315 NW 4th St Ste A",
            "city": "Redmond",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977561328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "YOUNG",
            "middle_name": "ROSE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lawrence Joseph Perez
• Mary Lauren Periman, CRM
• Jessica Perkins, PT, DPT
• Kimberly Ann Perlot, EPDH, RDH
• Donald Leon Peterson, OD
• Leif Eric Petterson Jr., NP
• Nichole Petterson, FNP
• Hailey Pettijohn
• Kelly R Pettit, MD
• Jean Amour Phare

• Physician Assistant in Redmond, OR
• Providers in Redmond, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.