Kibwey Roderick Andwele Peterkin, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

20 York Sreet
New Haven, CT 06510-3139

Phone

(203) 737-8867

NPI assigned

Aug 16, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kpeterkin715405@direct.ynhh.org

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1932827086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK SREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103139",
            "telephone_number": "203-737-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "KIBWEY",
        "middle_name": "RODERICK ANDWELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpeterki@bhmcny.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "1 Brookdale Plz",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112123139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William F Pesanelli, PT
• Petals Home Services
• Maya Petashnick
• Patricia R Peter, MD
• Steven Mark Peterec, MD
• Julie Elizabeth Peters, MD
• Nicholas Peters, MD
• Pamela Jean Petersen-Crair, MD
• Kitt Petersen, MD
• Nils H Petersen, M.D.

• Student in an Organized Health Care Education/Training Program in New Haven, CT
• Providers in New Haven, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.