1. Home
  2. Directory
  3. California
  4. Palo Alto
  5. Obstetrics Gynecology
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. KEVIN PETERSEN MD, MPH
NPI 1063158426
Obstetrics & Gynecology in Palo Alto, CA

Active since May 09, 2022PECOS Enrolled
423 QUARRY ROAD, DEPARTMENT OF OBGYN, MC 5317, PALO ALTO, CA 94304(650) 498-7570 Get Directions Write a Review

NPPES record last updated: August 31, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 31, 2026, May 9, 2022 (2 updates tracked since 2022).

About Dr. Kevin Petersen Md, Mph NPPES

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

DR. KEVIN PETERSEN MD, MPH (NPI 1063158426) is an individual obstetrics & gynecology provider in Palo Alto, California, licensed in California (A189433) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Francisco, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1063158426
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. KEVIN PETERSENCredential: MD, MPH
Location Address423 QUARRY ROAD, DEPARTMENT OF OBGYN, MC 5317Palo Alto, CA 94304-1419
Mailing Address423 Quarry Road, Department Of Obgyn, Mc 5317Palo Alto, CA 94304-1419 · (650) 498-7570
Phone(650) 498-7570
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 9, 2022
Last NPPES UpdateAugust 31, 20262 updates tracked since enumeration
NPPES CertifiedAugust 31, 2026
✔ NPI 1063158426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in CA · A189433
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
423 QUARRY ROAD, Palo Alto, CA 94304
Open in Google Maps ↗

Secondary Practice Location 1

Location 11100 Van Ness Ave Fl 4San Francisco, CA 94109-6978 · Phone (415) 750-7050

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Petersen Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7618434812
PECOS Enrollment IDI20260807000737
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.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Bay Medical Foundation
0.5 mi
Multi-Specialty
795 EL CAMINO REAL
Palo Alto, CA 94301
  • Reassigned Medicare billing, California enrollment
  • 4,479 clinicians in this Medicare group
NPI 1013950807 (650) 321-4121

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$156.67 typical visit price
range $70.37 – $206.04
Typical copayment $39.16 (range $17.59 – $51.51)
Most-billed visit code 99204
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Petersen's NPI number?

The NPI number for Kevin Petersen is 1063158426. It was assigned to this individual provider in the NPPES registry on May 9, 2022.

Where is Kevin Petersen located?

Kevin Petersen practices at 423 Quarry Road Department Of Obgyn, Mc 5317, Palo Alto, CA 94304. The listed phone number is (650) 498-7570.

What is Kevin Petersen's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kevin Petersen enrolled in Medicare?

Yes. Kevin Petersen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Petersen reassigns Medicare benefits to Sutter Bay Medical Foundation (Palo Alto, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kevin Petersen was last updated on August 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 51 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.