KEITH E PETERSEN DO
NPI 1356615470
Family Medicine - Adult Medicine in Tacoma, WA
About Keith E Petersen Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEITH E PETERSEN DO (NPI 1356615470) is an individual adult medicine provider in Tacoma, Washington, licensed in Washington (60595760) and active in the NPI registry since March 2012. He is enrolled in Medicare PECOS, is affiliated with Tacoma General Allenmore Hospital, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses
Accepted 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
Keith E Petersen Do 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.
Medicare Billing Reassignment
Medicare enrollment records show Keith Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lakewood, WA 98499
- Reassigned Medicare billing, Washington enrollment
- 4,383 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Tacoma General Allenmore Hospital
Acute Care Hospitals · Tacoma, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98431 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TACOMA, WA 98431
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 Keith Petersen's NPI number?
The NPI number for Keith Petersen is 1356615470. It was assigned to this individual provider in the NPPES registry on March 7, 2012.
Where is Keith Petersen located?
Keith Petersen practices at 9040 Jackson Ave, Tacoma, WA 98431. The listed phone number is (253) 968-1340.
What is Keith Petersen's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.
Is Keith Petersen enrolled in Medicare?
Yes. Keith Petersen 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 organization bills Medicare for Keith Petersen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keith Petersen reassigns Medicare benefits to Multicare Health System (Lakewood, WA). 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 Keith Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Keith Petersen accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Keith Petersen 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 Keith Petersen affiliated with any hospitals?
According to CMS data, Keith Petersen is affiliated with Tacoma General Allenmore Hospital.
When was this NPI record last updated?
The NPPES record for Keith Petersen was last updated on March 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Keith E Petersen, DO · NPI 1356615470
Adult Medicine physician in Tacoma, Washington. Individual provider, active in the CMS NPPES registry since March 7, 2012.
## Identity
- **NPI:** 1356615470 (Entity type: Individual)
- **Enumerated:** March 7, 2012
- **Primary specialty:** Family Medicine - Adult Medicine · taxonomy 207QA0505X
- **State license:** 60595760 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 9040 JACKSON AVE, Tacoma, WA 98431-1000
- **Phone:** (253) 968-1340
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Multicare Health System (NPI 1790298081, Lakewood, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** March 12, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1356615470) · Data from the CMS NPPES public registry.