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MARY KATHRYN PETERSON D.O.
NPI 1356508675
Family Medicine in Skokie, IL

Active since May 22, 2008PECOS EnrolledAccepts Medicare Assignment
4999 OLD ORCHARD SHOPPING CENTER, F12 & F13, SKOKIE, IL 60077(888) 663-6331 Get Directions Write a Review

NPPES record last updated: July 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 20, 2026, Oct 12, 2020 (2 updates tracked since 2020).

About Mary Kathryn Peterson D.o. NPPES

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

MARY KATHRYN PETERSON D.O. (NPI 1356508675) is an individual family medicine provider in Skokie, Illinois, licensed in Illinois (036121820) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS, is affiliated with Presence Saint Francis Hospital, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2006).

NPPES Registry Identity

NPI1356508675
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMARY KATHRYN PETERSONCredential: D.O.
Location Address4999 OLD ORCHARD SHOPPING CENTER, F12 & F13Skokie, IL 60077
Mailing Address1 Embarcadero Ctr Ste 1900San Francisco, CA 94111-3723 · (888) 663-6331
Phone(888) 663-6331
Sole ProprietorNo
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2006
Enumeration DateMay 22, 2008
Last NPPES UpdateJuly 20, 20262 updates tracked since enumeration
NPPES CertifiedJuly 20, 2026
✔ NPI 1356508675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036121820
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4999 OLD ORCHARD SHOPPING CENTER, Skokie, IL 60077
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Other Names 1

Former Name (1)Mary Kathryn Doran Do

Other Identifiers 1

Medicaid036121820IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Kathryn Peterson D.o. 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 ID5799830626
PECOS Enrollment IDI20090828000428
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 Reassignments

2

Medicare enrollment records show Mary Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prime Healthcare Illinois Medical Group LLC
6.1 mi
Multi-Specialty
2380 E DEMPSTER ST
Des Plaines, IL 60016
  • Reassigned Medicare billing, Illinois enrollment
  • 443 clinicians in this Medicare group
NPI 1023837689 (833) 291-0464
One Medical Group, Inc.
14 mi
Family Medicine
181 W MADISON ST STE 3825
Chicago, IL 60602
  • Reassigned Medicare billing, Illinois enrollment
  • 31 clinicians in this Medicare group
NPI 1588382832 (312) 219-2230

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

Areas of Expertise CMS Part B claims 11

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.

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
182 services182 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.
148 services122 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
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.
54 services50 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
48 services46 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
44 services43 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
28 services28 patients

Hospital Affiliations CMS Care Compare 4

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

Presence Saint Francis Hospital

Acute Care Hospitals · Evanston, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140080
Location355 Ridge AveEvanston, IL 60202 · Cook County
Emergency services

Amita Health Resurrection Medical Center

Acute Care Hospitals · Chicago, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140117
Location7435 W Talcott AvenueChicago, IL 60631 · Cook County
Emergency services Birthing friendly

Presence Saints Mary And Elizabeth Medical Center

Acute Care Hospitals · Chicago, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140180
Location2233 W Division StChicago, IL 60622 · Cook County
Emergency services Birthing friendly

Advocate Lutheran General Hospital

Acute Care Hospitals · Park Ridge, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140223
Location1775 Dempster StPark Ridge, IL 60068 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60077 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
71%85 patients3/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
79%147 patients4/55-star benchmark: 100%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
3%122 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers18 claims48 services$5.98 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers12 claims18 services$1.16 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

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

ANDREW MICHAEL DAHLEM JR. M. D.
Family Medicine
4999 OLD ORCHARD SHOPPING CENTER, N10 & N7
SKOKIE, IL 60077
Cook County (405) 658-6791

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 Mary Peterson's NPI number?

The NPI number for Mary Peterson is 1356508675. It was assigned to this individual provider in the NPPES registry on May 22, 2008. The provider is also known as Mary Kathryn Doran Do.

Where is Mary Peterson located?

Mary Peterson practices at 4999 Old Orchard Shopping Center F12 & F13, Skokie, IL 60077. The listed phone number is (888) 663-6331.

What is Mary Peterson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mary Peterson enrolled in Medicare?

Yes. Mary 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.

Which organizations bill Medicare for Mary Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Peterson reassigns Medicare benefits to 2 organizations: Prime Healthcare Illinois Medical Group LLC (Des Plaines, IL) and One Medical Group, Inc. (Chicago, IL). Each 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 Mary Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mary Peterson accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Mary 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 Mary Peterson affiliated with any hospitals?

According to CMS data, Mary Peterson is affiliated with Presence Saint Francis Hospital, Amita Health Resurrection Medical Center, Presence Saints Mary And Elizabeth Medical Center and Advocate Lutheran General Hospital.

When was this NPI record last updated?

The NPPES record for Mary Peterson was last updated on July 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.