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KOMEKIA PETERSON
NPI 1730062571
Counselor - Mental Health in Rochester, NY

Active since July 29, 2025PECOS Enrolled
993 STOWELL DR, ROCHESTER, NY 14616(585) 698-4549(585) 698-4549 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Komekia Peterson NPPES

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

KOMEKIA PETERSON (NPI 1730062571) is an individual mental health provider in Rochester, New York, licensed in New York (008405) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Bayside, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1730062571
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKOMEKIA PETERSON
Location Address993 STOWELL DRRochester, NY 14616-1849
Mailing Address993 Stowell DrRochester, NY 14616-1849 · (585) 698-4549 · Fax (585) 698-4549
Phone(585) 698-4549
Fax(585) 698-4549
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 29, 2025
Last NPPES UpdateSeptember 10, 2025
NPPES CertifiedSeptember 10, 2025
✔ NPI 1730062571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 008405
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 34381 (NY)

Secondary Practice Location 1

Location 13635 Bell Blvd Ste 203Bayside, NY 11361-2097 · Phone (718) 504-9256 ext. 49256

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Komekia Peterson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9436654878
PECOS Enrollment IDI20250925002917
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.

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 Komekia Peterson's NPI number?

The NPI number for Komekia Peterson is 1730062571. It was assigned to this individual provider in the NPPES registry on July 29, 2025.

Where is Komekia Peterson located?

Komekia Peterson practices at 993 Stowell Dr, Rochester, NY 14616. The listed phone number is (585) 698-4549.

What is Komekia Peterson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Komekia Peterson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Komekia Peterson was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.