KERI PETERSON PA-C
NPI 1639953243
Physician Assistant in Missoula, MT

Q: What is Keri Peterson's NPI number?

The NPI number for Keri Peterson is 1639953243. It was assigned to this individual provider in the NPPES registry on August 23, 2023.

Q: What is Keri Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Keri Peterson was last updated on April 22, 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.

Active since August 23, 2023PECOS EnrolledAccepts Medicare Assignment

1821 SOUTH AVE W STE 402, MISSOULA, MT 59801(406) 543-8512(406) 541-8513 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 22, 2026, Dec 21, 2025, Aug 23, 2023 (3 updates tracked since 2023).

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About Keri Peterson Pa-c NPPES

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

KERI PETERSON PA-C (NPI 1639953243) is an individual physician assistant in Missoula, Montana, licensed in Montana (MED-PAC-LIC-160046) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Missoula, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1639953243

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKERI PETERSONCredential: PA-C

Location Address1821 SOUTH AVE W STE 402Missoula, MT 59801-6518

Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008 · Fax (920) 684-1439

Phone(406) 543-8512

Fax(406) 541-8513

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 23, 2023

Last NPPES UpdateApril 22, 20263 updates tracked since enumeration

NPPES CertifiedApril 22, 2026

✔ NPI 1639953243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MT · MED-PAC-LIC-160046

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1821 SOUTH AVE W STE 402, Missoula, MT 59801

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Secondary Practice Location 1

Location 12875 Tina Ave Ste 104Missoula, MT 59808-1582 · Phone (406) 613-7676 · Fax (406) 206-6316

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Keri Peterson Pa-c 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 ID1456837004

PECOS Enrollment IDI20260113003084

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 59801 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

$87.97 typical visit price

range $56.81 – $172.26

Typical copayment $21.99 (range $14.20 – $43.06)

Most-billed visit code 99203

Established Patient

$70.82 typical visit price

range $18.24 – $140.32

Typical copayment $17.70 (range $4.56 – $35.08)

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 7

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

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