KELLY PETERSON ARNP
NPI 1164087730
Nurse Practitioner - Adult Health in Tacoma, WA

Active since May 08, 2019PECOS EnrolledAccepts Medicare Assignment
1901 S CEDAR ST STE 101, TACOMA, WA 98405(253) 301-5370 Get Directions Write a Review

NPPES record last updated: February 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 23, 2021, Nov 12, 2020, May 8, 2019 (3 updates tracked since 2019).

About Kelly Peterson Arnp NPPES

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

KELLY PETERSON ARNP (NPI 1164087730) is an individual adult health provider in Tacoma, Washington, licensed in Washington (AP61095811) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Multicare Good Samaritan Hospital, and maintains a secondary practice location in Columbus.

NPPES Registry Identity

NPI1164087730
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameKELLY PETERSONCredential: ARNP
Location Address1901 S CEDAR ST STE 101Tacoma, WA 98405-2302
Mailing Address1901 S Cedar St Ste 101Tacoma, WA 98405-2302
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2019
Enumeration DateMay 8, 2019
Last NPPES UpdateFebruary 23, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2021
NPI 1164087730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in WA · AP61095811
Also ListedRegistered NurseTaxonomy 163W00000X · License RN.382825 (OH)
Also ListedNurse Practitioner · Critical Care MedicineTaxonomy 363LC0200X · License APRN.CNP.025246 (OH)
1901 S CEDAR ST STE 101, Tacoma, WA 98405

Secondary Practice Location 1

Location 1410 W 10th AveColumbus, OH 43210-1240 · Phone (614) 293-8000

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kelly Peterson Arnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537490230
PECOS Enrollment IDI20201118002113
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 CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services18 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services13 patients
Evaluation of lower heart chamber assist device 93750
An evaluation of a lower heart chamber assist device is a procedure to check the function of an implanted device aiding your heart's lower chambers. This helps ensure optimal heart function by monitoring the device's performance and your heart's response to it.
15 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Multicare Good Samaritan Hospital

Acute Care Hospitals · Puyallup, WA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500079
Location401 15th Avenue SEPuyallup, WA 98372 · Pierce County
Emergency services Birthing friendly

Tacoma General Allenmore Hospital

Acute Care Hospitals · Tacoma, WA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500129
Location315 S Mlk Jr WayTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98405 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
2 suppliers14 claims14 services$18.39 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
2 suppliers30 claims148 services$35.37 avg. paid by Medicare
Injection, milrinone lactate, 5 mg J2260
Treatment-Injections and Infusions (nononcologic) · category RI026N
2 suppliers33 claims1,301 services$1.29 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Acute Care)
1901 S CEDAR ST STE 101
TACOMA, WA 98405
Nurse Practitioner (Adult Health)
1901 S CEDAR ST STE 101
TACOMA, WA 98405
Nurse Practitioner (Acute Care)
1901 S CEDAR ST STE 101
TACOMA, WA 98405
Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
1901 S CEDAR ST STE 101
TACOMA, WA 98405

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 Kelly Peterson's NPI number?

The NPI number for Kelly Peterson is 1164087730. It was assigned to this individual provider in the NPPES registry on May 8, 2019.

Where is Kelly Peterson located?

Kelly Peterson practices at 1901 S Cedar St Ste 101, Tacoma, WA 98405. The listed phone number is (253) 301-5370.

What is Kelly Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Kelly Peterson enrolled in Medicare?

Yes. Kelly Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Peterson accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Kelly Peterson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Peterson affiliated with any hospitals?

According to CMS data, Kelly Peterson is affiliated with Multicare Good Samaritan Hospital and Tacoma General Allenmore Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Peterson was last updated on February 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.