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KENNETH PETTERSEN MD, MPH
NPI 1710371927
Internal Medicine in Sylmar, CA

Active since March 25, 2015PECOS EnrolledAccepts Medicare Assignment
14445 OLIVE VIEW DR # 2D-154, SYLMAR, CA 91342(747) 210-4990(747) 210-4573 Get Directions Write a Review

NPPES record last updated: December 31, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kenneth Pettersen Md, Mph NPPES

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

KENNETH PETTERSEN MD, MPH (NPI 1710371927) is an individual internal medicine provider in Sylmar, California, licensed in California (A147825) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (2015).

NPPES Registry Identity

NPI1710371927
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKENNETH PETTERSENCredential: MD, MPH
Location Address14445 OLIVE VIEW DR # 2D-154Sylmar, CA 91342-1437
Mailing Address14445 Olive View Dr # 2b182Sylmar, CA 91342-1438 · (747) 210-3205 · Fax (747) 210-4573
Phone(747) 210-4990
Fax(747) 210-4573
Sole ProprietorNo
Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 2015
Enumeration DateMarch 25, 2015
Last NPPES UpdateDecember 31, 2019
✔ NPI 1710371927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A147825
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
14445 OLIVE VIEW DR # 2D-154, Sylmar, CA 91342
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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

Kenneth Pettersen Md, Mph 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 ID2567736119
PECOS Enrollment IDI20180222002572
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 Kenneth Pettersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Los Angeles Auditor Controller
0.2 mi
General Acute Care Hospital
14445 OLIVE VIEW DR
Sylmar, CA 91342
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: County Of Los Angeles
  • 1,939 clinicians in this Medicare group
NPI 1134159320 (818) 364-3031

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 91342 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers22 claims60 services$3.35 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers11 claims20 services$0.51 avg. paid by Medicare
Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185
Other-Enteral and Parenteral · category OB005N
1 supplier20 claims690 services$10.92 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix B4193
Other-Enteral and Parenteral · category OB005N
1 supplier18 claims126 services$228.76 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier19 claims131 services$7.97 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier20 claims138 services$24.90 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Kenneth Pettersen's NPI number?

The NPI number for Kenneth Pettersen is 1710371927. It was assigned to this individual provider in the NPPES registry on March 25, 2015.

Where is Kenneth Pettersen located?

Kenneth Pettersen practices at 14445 Olive View Dr # 2d-154, Sylmar, CA 91342. The listed phone number is (747) 210-4990.

What is Kenneth Pettersen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kenneth Pettersen enrolled in Medicare?

Yes. Kenneth Pettersen 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 organization bills Medicare for Kenneth Pettersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Pettersen reassigns Medicare benefits to County Of Los Angeles Auditor Controller (Sylmar, CA). 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 Kenneth Pettersen'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 Kenneth Pettersen was last updated on December 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.