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KEVIN LYMAN PETERSON PA-C
NPI 1689308744
Physician Assistant in West Jordan, UT

Active since July 14, 2022PECOS EnrolledAccepts Medicare Assignment
3570 W 9000 S, WEST JORDAN, UT 84088(801) 903-5620(385) 351-6718 Get Directions Write a Review

NPPES record last updated: November 26, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2024, May 2, 2024, Jul 14, 2022 (3 updates tracked since 2022).

About Kevin Lyman Peterson Pa-c NPPES

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

KEVIN LYMAN PETERSON PA-C (NPI 1689308744) is an individual physician assistant in West Jordan, Utah, licensed in Utah (12857669-1206) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS, is affiliated with Holy Cross Hospital-jordan Valley, and maintains a secondary practice location in Murray.

NPPES Registry Identity

NPI1689308744
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKEVIN LYMAN PETERSONCredential: PA-C
Location Address3570 W 9000 SWest Jordan, UT 84088-8869
Mailing Address5242 S College Dr Ste 200Murray, UT 84123-2918
Phone(801) 903-5620
Fax(385) 351-6718
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 14, 2022
Last NPPES UpdateNovember 26, 20243 updates tracked since enumeration
NPPES CertifiedNovember 26, 2024
✔ NPI 1689308744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in UT · 12857669-1206
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.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 12857669-1206 (UT)
3570 W 9000 S, West Jordan, UT 84088
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Secondary Practice Location 1

Location 15242 S College Dr Ste 200Murray, UT 84123-2918 · Phone (385) 365-5053

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, University of Utah Health Plans.Insurance ›

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

Kevin Lyman 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 ID3173062148
PECOS Enrollment IDI20240822002832
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
12 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Holy Cross Hospital-Jordan Valley

Acute Care Hospitals · West Jordan, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460051
Location3580 West 9000 SouthWest Jordan, UT 84088 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84088 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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 16

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

FRANCES BECHEK M.D.
Obstetrics & Gynecology
3570 W 9000 S, #210
WEST JORDAN, UT 84088
Salt Lake County (801) 569-2626
BARI MICHELLE KING F.N.P.
Nurse Practitioner (Family)
3570 W 9000 S, SUITE, 100
WEST JORDAN, UT 84088
Salt Lake County (801) 569-1999
JACOLIN DEHLER SHIFRAR CNM
Advanced Practice Midwife
3570 W 9000 S, #210
WEST JORDAN, UT 84088
Salt Lake County (801) 569-2626
MARIA A ONEIDA M.D.
Family Medicine
3570 W 9000 S, STE 200
WEST JORDAN, UT 84088
Salt Lake County (801) 566-9211
SOUTH VALLEY WOMEN'S IMAGING, LLC
Specialist
3570 W 9000 S, #130
WEST JORDAN, UT 84088
Salt Lake County (801) 569-2626
MARIA C RUGAMAS CFA
Specialist/Technologist, Other (Surgical Assistant)
3570 W 9000 S, SUITE 210
WEST JORDAN, UT 84088
Salt Lake County (801) 569-5328
ARLEN K JARRETT MD
Specialist
3570 W 9000 S, #210
WEST JORDAN, UT 84088
Salt Lake County (801) 569-2626
JORDAN VALLEY FAMILY HEALTH
Family Medicine
3570 W 9000 S, SUITE #100
WEST JORDAN, UT 84088
Salt Lake County (801) 569-1999

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 1689308744. It was assigned to this individual provider in the NPPES registry on July 14, 2022.

Where is Kevin Peterson located?

Kevin Peterson practices at 3570 W 9000 S, West Jordan, UT 84088. The listed phone number is (801) 903-5620.

What is Kevin Peterson's specialty?

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

Is Kevin Peterson enrolled in Medicare?

Yes. Kevin Peterson 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.

What insurance does Kevin Peterson accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Kevin Peterson 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 Peterson affiliated with any hospitals?

According to CMS data, Kevin Peterson is affiliated with Holy Cross Hospital-Jordan Valley.

When was this NPI record last updated?

The NPPES record for Kevin Peterson was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.