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DR. KEVIN PETERSEN MD, MPH
NPI 1063158426
Student in an Organized Health Care Education/Training Program 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: May 9, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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 student in an organized health care education/training program in Palo Alto, California and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063158426
Entity TypeIndividualMale
Primary Taxonomy390200000X
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
Enumeration DateMay 9, 2022
NPPES CertifiedApril 25, 2022
✔ NPI 1063158426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
423 QUARRY ROAD, Palo Alto, CA 94304
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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. Kevin Petersen Md, Mph 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.

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 Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kevin Petersen enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kevin Petersen was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.