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KATHY L PETERSBURG ARNP
NPI 1508860974
Nurse Practitioner - Family in Decorah, IA

Active since June 13, 2005PECOS Enrolled
97.58/100
CMS Quality Rating
901 MONTGOMERY ST, DECORAH, IA 52101(563) 382-2911(563) 387-3102 Get Directions Write a Review

NPPES record last updated: January 22, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kathy L Petersburg Arnp NPPES

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

KATHY L PETERSBURG ARNP (NPI 1508860974) is an individual family provider in Decorah, Iowa, licensed in Iowa (J073230) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508860974
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKATHY L PETERSBURGCredential: ARNP
Location Address901 MONTGOMERY STDecorah, IA 52101-2325
Mailing Address2253 Madison RdDecorah, IA 52101-7813
Phone(563) 382-2911
Fax(563) 387-3102
Sole ProprietorNo
Enumeration DateJune 13, 2005
Last NPPES UpdateJanuary 22, 2015
✔ NPI 1508860974 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in IA · J073230✔ Licensed in MN · 0696743-1
901 MONTGOMERY ST, Decorah, IA 52101
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINS30319MN
Medicaid838721400MN
Medicare PINI14849IA
Medicaid1432070IA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathy L Petersburg Arnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Kathy Petersburg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Winneshiek Medical Center
Same address
Nurse Anesthetist, Certified Registered
901 MONTGOMERY ST
Decorah, IA 52101
  • Reassigned Medicare billing, Iowa and Minnesota enrollments
  • Also billed through NPI 1619922051 (Iowa), NPI 1093857393 (Minnesota)
  • 170 clinicians in this Medicare group
NPI 1023022803 (952) 442-9770

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52101 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

DR. RANDALL J BREMNER M.D.
Obstetrics & Gynecology
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-2911
ERIC WILLIAM SVESTKA M.D.
Family Medicine
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-2911
NANCY J GILSON RN DIABETES EDUCATOR
Registered Nurse (Diabetes Educator)
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-2911
HANNAH GAVESKE ATC
Specialist/Technologist (Athletic Trainer)
901 MONTGOMERY ST, REHABILITATION SERVICES
DECORAH, IA 52101
Winneshiek County (563) 382-2911
CHRIS TRYTTEN
Specialist/Technologist (Athletic Trainer)
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-2911
DOUGLAS O VOGELSON JR. AU.D.
Audiologist-Hearing Aid Fitter
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-9671
WINNESHIEK MEDICAL CENTER
Nurse Anesthetist, Certified Registered
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (952) 442-9770
MS. TAYLOR JO SNYDER RN
Registered Nurse (Emergency)
901 MONTGOMERY ST
DECORAH, IA 52101
Winneshiek County (563) 382-2911

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 Kathy Petersburg's NPI number?

The NPI number for Kathy Petersburg is 1508860974. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Kathy Petersburg located?

Kathy Petersburg practices at 901 Montgomery St, Decorah, IA 52101. The listed phone number is (563) 382-2911.

What is Kathy Petersburg's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kathy Petersburg enrolled in Medicare?

Yes. Kathy Petersburg is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kathy Petersburg's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathy Petersburg reassigns Medicare benefits to Winneshiek Medical Center (Decorah, IA). 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 Kathy Petersburg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kathy Petersburg was last updated on January 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.