1. Home
  2. Directory
  3. Florida
  4. Pensacola
  5. Surgery
  6. NPI Profile

DR. KEVIN THOMAS PETERSEN D.O.
NPI 1356778419
Surgery in Pensacola, FL

Active since October 03, 2013PECOS EnrolledAccepts Medicare Assignment
220 HOVEY RD FL 32508, PENSACOLA, FL 32508(850) 452-9484 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 15, 2021, Sep 16, 2019 (2 updates tracked since 2019).

About Dr. Kevin Thomas Petersen D.o. NPPES

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

DR. KEVIN THOMAS PETERSEN D.O. (NPI 1356778419) is an individual surgery provider in Pensacola, Florida, licensed in Nevada (DO3578) and active in the NPI registry since October 2013. He is enrolled in Medicare PECOS, is affiliated with University Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1356778419
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. KEVIN THOMAS PETERSENCredential: D.O.
Location Address220 HOVEY RD FL 32508Pensacola, FL 32508-1044
Mailing Address220 Hovey Rd Fl 32508Pensacola, FL 32508-1044
Phone(850) 452-9484
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 3, 2013
Last NPPES UpdateJuly 30, 20252 updates tracked since enumeration
NPPES CertifiedJuly 30, 2025
✔ NPI 1356778419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in NV · DO3578✔ Licensed in NY · 294233
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
220 HOVEY RD FL 32508, Pensacola, FL 32508
Open in Google Maps ↗

Accepted Insurance

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

Dr. Kevin Thomas Petersen 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 ID8426389495
PECOS Enrollment IDI20240821001320, I20260804002608
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 Kevin Petersen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Unlv Medicine
1,652 mi
Community/Behavioral Health
4000 E CHARLESTON BLVD STE 130
Las Vegas, NV 89104
  • Reassigned Medicare billing, Nevada enrollment
  • 286 clinicians in this Medicare group
NPI 1851811525 (702) 968-4000
Acute Care Surgery Medical Group, Inc.
2,019 mi
Surgery
2801 K STREET SUITE 440
Sacramento, CA 95816
  • Reassigned Medicare billing, California enrollment
  • 266 clinicians in this Medicare group
NPI 1700069549 (916) 441-0400

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.

University Medical Center

Acute Care Hospitals · Las Vegas, NV
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number290007
Location1800 W Charleston BlvdLas Vegas, NV 89102 · Clark County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32508 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

Other Providers at the Same Location NPPES

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

DR. DEREK LODICO DO
Preventive Medicine (Undersea and Hyperbaric Medicine)
220 HOVEY RD FL 32508
PENSACOLA, FL 32508
Escambia County (323) 226-4102

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 1356778419. It was assigned to this individual provider in the NPPES registry on October 3, 2013.

Where is Kevin Petersen located?

Kevin Petersen practices at 220 Hovey Rd Fl 32508, Pensacola, FL 32508. The listed phone number is (850) 452-9484.

What is Kevin Petersen's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Kevin Petersen enrolled in Medicare?

Yes. Kevin 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 organizations bill Medicare for Kevin Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Petersen reassigns Medicare benefits to 2 organizations: Unlv Medicine (Las Vegas, NV) and Acute Care Surgery Medical Group, Inc. (Sacramento, CA). 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 Kevin Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Petersen accept?

Health plans from Ambetter Health and Molina Healthcare list Kevin 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 Kevin Petersen affiliated with any hospitals?

According to CMS data, Kevin Petersen is affiliated with University Medical Center.

When was this NPI record last updated?

The NPPES record for Kevin Petersen was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.