DR. KELSEY CARL PETERSON JR. M.D.
NPI 1033281019
Specialist in Huntington Beach, CA

Active since November 14, 2006PECOS Enrolled
17742 BEACH BLVD, 245, HUNTINGTON BEACH, CA 92647(714) 329-0179(714) 965-0311 Get Directions Write a Review

NPPES record last updated: March 15, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Kelsey Carl Peterson Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELSEY CARL PETERSON JR. M.D. (NPI 1033281019) is an individual specialist in Huntington Beach, California, licensed in California (G17592) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033281019
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. KELSEY CARL PETERSON JR.Credential: M.D.
Location Address17742 BEACH BLVD, 245Huntington Beach, CA 92647-6818
Mailing Address20462 Kenworth CirHuntington Beach, CA 92646-5446 · (714) 329-0179 · Fax (714) 965-0311
Fax(714) 965-0311
Sole ProprietorYes
Enumeration DateNovember 14, 2006
Last NPPES UpdateMarch 15, 2016
NPI 1033281019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in CA · G17592
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

17742 BEACH BLVD, Huntington Beach, CA 92647

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Kelsey Carl Peterson Jr. M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 26 times for 13 patients

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Family Medicine
17742 BEACH BLVD, STE 215
HUNTINGTON BEACH, CA 92647
General Practice
17742 BEACH BLVD, STE 215
HUNTINGTON BEACH, CA 92647
Family Medicine
17742 BEACH BLVD, STE 215
HUNTINGTON BEACH, CA 92647
Pediatrics (Adolescent Medicine)
17742 BEACH BLVD, SUITE 360
HUNTINGTON BEACH, CA 92647
Internal Medicine (Cardiovascular Disease)
17742 BEACH BLVD, SUITE #230
HUNTINGTON BEACH, CA 92647
Ophthalmology
17742 BEACH BLVD, SUITE 305
HUNTINGTON BEACH, CA 92647
Plastic Surgery
17742 BEACH BLVD, SUITE 335
HUNTINGTON BEACH, CA 92647
Pediatrics (Adolescent Medicine)
17742 BEACH BLVD, SUITE 240
HUNTINGTON BEACH, CA 92647
Dermatology
17742 BEACH BLVD, SUITE #325
HUNTINGTON BEACH, CA 92647
Pharmacy (Community/Retail Pharmacy)
17742 BEACH BLVD, SUITE 100
HUNTINGTON BEACH, CA 92647
Pharmacist
17742 BEACH BLVD, SUITE 100
HUNTINGTON BEACH, CA 92647
Dentist (General Practice)
17742 BEACH BLVD, #350
HUNTINGTON BEACH, CA 92647
Clinic/Center (Ambulatory Surgical)
17742 BEACH BLVD, STE. #335
HUNTINGTON BEACH, CA 92647
Pediatrics (Adolescent Medicine)
17742 BEACH BLVD, SUITE 240
HUNTINGTON BEACH, CA 92647
Internal Medicine (Cardiovascular Disease)
17742 BEACH BLVD, SUITE #230
HUNTINGTON BEACH, CA 92647
Dermatology
17742 BEACH BLVD, SUITE 325
HUNTINGTON BEACH, CA 92647
Optometrist
17742 BEACH BLVD, 305
HUNTINGTON BEACH, CA 92647
Pediatrics (Adolescent Medicine)
17742 BEACH BLVD, SUITE 240
HUNTINGTON BEACH, CA 92647
Dentist (Pediatric Dentistry)
17742 BEACH BLVD, SUITE 320
HUNTINGTON BEACH, CA 92647
Nurse Practitioner (Pediatrics)
17742 BEACH BLVD, #240
HUNTINGTON BEACH, CA 92647

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033281019, enumerated as an "individual" on November 14, 2006.

The provider is located at 17742 BEACH BLVD 245 HUNTINGTON BEACH, CA 92647 and the phone number is (714) 329-0179.

Specialist with taxonomy code 174400000X.