DR. KEVIN WILLIAM PETERSON M.D.
NPI 1790754877
Family Medicine in Jacksonville, FL

Q: What is Kevin Peterson's NPI number?

The NPI number for Kevin Peterson is 1790754877. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Kevin Peterson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kevin Peterson was last updated on April 22, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2006PECOS Enrolled

2377 DUNN AVE, UFJP DUNN AVENUE FAMILY PRACTICE CENTER, JACKSONVILLE, FL 32218(904) 633-0700(904) 633-0701 Get Directions Write a Review

NPPES record last updated: April 22, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Kevin William Peterson M.d. NPPES

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

DR. KEVIN WILLIAM PETERSON M.D. (NPI 1790754877) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (ME81505) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790754877

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KEVIN WILLIAM PETERSONCredential: M.D.

Location Address2377 DUNN AVE, UFJP DUNN AVENUE FAMILY PRACTICE CENTERJacksonville, FL 32218-6983

Mailing AddressPo Box 44008, Ufjp Provider EnrollmentJacksonville, FL 32231-4008

Phone(904) 633-0700

Fax(904) 633-0701

Sole ProprietorNo

Enumeration DateMarch 14, 2006

Last NPPES UpdateApril 22, 2009

✔ NPI 1790754877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · ME81505

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.

2377 DUNN AVE, Jacksonville, FL 32218

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Other Identifiers 5

Medicare PIN01667ZFL

Medicaid2618401-00FL

Other080175129FL · Railroad Medicare

Medicare UPINH43192FL

Medicaid000912007AGA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin William Peterson M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32218 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

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