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KEVIN A PETERSON MD
NPI 1538243779
Family Medicine in Minneapolis, MN

Active since October 24, 2006PECOS Enrolled
2001 BLOOMINGTON AVE, MINNEAPOLIS, MN 55404(612) 638-0700(612) 627-4205 Get Directions Write a Review

NPPES record last updated: January 28, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Kevin A Peterson Md NPPES

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

KEVIN A PETERSON MD (NPI 1538243779) is an individual family medicine provider in Minneapolis, Minnesota, licensed in Minnesota (31945) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538243779
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKEVIN A PETERSONCredential: MD
Location Address2001 BLOOMINGTON AVEMinneapolis, MN 55404-3074
Mailing Address420 Delaware St Se, University Of Minnesota PhysiciansMinneapolis, MN 55455-0341 · (651) 772-3461
Phone(612) 638-0700
Fax(612) 627-4205
Sole ProprietorNo
Enumeration DateOctober 24, 2006
Last NPPES UpdateJanuary 28, 2013
✔ NPI 1538243779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 31945
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.
2001 BLOOMINGTON AVE, Minneapolis, MN 55404
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Other Identifiers 8

Other768302MN · Araz
Other1008691MN · Preferred One
Medicaid267390800MN
Other55D00PEMN · Blue Cross Blue Shield
Other01-00482MN · Medica Choice
Other102872MN · Ucare
OtherHP16946MN · Health Partners
Medicare UPINA95699

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin A Peterson Md 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 Kevin Peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fairview Express Care
0.7 mi
Multi-Specialty
2312 S 6TH ST STE F105
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1053952606 (612) 273-3565

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 55404 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

ALICIA GRUND MSW, LICSW
Social Worker (Clinical)
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 301-0880
MOLLIE A MCFAGGEN PHARMD
Pharmacist
2001 BLOOMINGTON AVE, COMMUNITY UNIVERSITY HEALTH CARE CENTER
MINNEAPOLIS, MN 55404
Hennepin County (612) 638-0700
EMILY KATE OTTESON BAN, RN, PHN
Student in an Organized Health Care Education/Training Program
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 301-3433
BRENDA BECK REITER NP
Nurse Practitioner (Women's Health)
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 638-0700
DR. MICHELE LEE ALLEN M.D.
Family Medicine
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 638-0700
LAN PARKER LUU M.D., M.P.H.
Internal Medicine
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 301-3433
ANDREA CHARLOTTE DAVIS APRN
Nurse Practitioner (Family)
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 301-3433
MICHAEL J AYLWARD M.D.
Internal Medicine
2001 BLOOMINGTON AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 638-0700

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 Peterson's NPI number?

The NPI number for Kevin Peterson is 1538243779. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Where is Kevin Peterson located?

Kevin Peterson practices at 2001 Bloomington Ave, Minneapolis, MN 55404. The listed phone number is (612) 638-0700.

What is Kevin Peterson's specialty?

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

Is Kevin Peterson enrolled in Medicare?

Yes. Kevin Peterson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Peterson reassigns Medicare benefits to Fairview Express Care (Minneapolis, MN). 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 Kevin Peterson'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 Kevin Peterson was last updated on January 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.