TYSEN J PETRE D.O.
NPI 1871642470
Family Medicine in Kirksville, MO

Q: What is Tysen Petre's NPI number?

The NPI number for Tysen Petre is 1871642470. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Q: What is Tysen Petre'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 Tysen Petre was last updated on September 16, 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.

Active since January 10, 2007PECOS EnrolledAccepts Medicare Assignment

1611 S BALTIMORE ST, KIRKSVILLE, MO 63501(660) 665-7575(660) 665-7576 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 16, 2025, May 20, 2020, Oct 25, 2019 (3 updates tracked since 2019).

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About Tysen J Petre D.o. NPPES

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

TYSEN J PETRE D.O. (NPI 1871642470) is an individual family medicine provider in Kirksville, Missouri, licensed in Missouri (2006004444) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Northeast Regional Medical Center, and maintains a secondary practice location in Macon.

NPPES Registry Identity

NPI1871642470

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTYSEN J PETRECredential: D.O.

Location Address1611 S BALTIMORE STKirksville, MO 63501-4518

Mailing Address1611 S Baltimore StKirksville, MO 63501-4518 · (660) 665-7575 · Fax (660) 665-7576

Phone(660) 665-7575

Fax(660) 665-7576

Sole ProprietorNo

Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2004

Enumeration DateJanuary 10, 2007

Last NPPES UpdateSeptember 16, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 16, 2025

✔ NPI 1871642470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2006004444

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.

1611 S BALTIMORE ST, Kirksville, MO 63501

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Secondary Practice Location 1

Location 11206 N Missouri StMacon, MO 63552-2149 · Phone (660) 395-7575 · Fax (660) 665-7576

Other Identifiers 1

OtherBNDDMO · 400608434

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.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

Tysen J Petre D.o. 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 ID7719080845

PECOS Enrollment IDI20070312000033

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.

Hospital Affiliations CMS Care Compare 5

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

Northeast Regional Medical Center

Acute Care Hospitals · Kirksville, MO

3/5 CMS rating

OwnershipProprietary

CMS Certification Number260022

Location315 S OsteopathyKirksville, MO 63501 · Adair County

Emergency services Birthing friendly

Boone Hospital Center

Acute Care Hospitals · Columbia, MO

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number260068

Location1600 E BroadwayColumbia, MO 65201 · Boone County

Emergency services Birthing friendly

Moberly Regional Medical Center

Acute Care Hospitals · Moberly, MO

3/5 CMS rating

OwnershipProprietary

CMS Certification Number260074

Location1515 Union AveMoberly, MO 65270 · Randolph County

Emergency services

Pershing Memorial Hospital

Critical Access Hospitals · Brookfield, MO

OwnershipVoluntary non-profit - Private

CMS Certification Number261307

Location130 East LocklingBrookfield, MO 64628 · Linn County

Emergency services

Macon County Samaritan Memorial Hospital

Critical Access Hospitals · Macon, MO

OwnershipGovernment - Local

CMS Certification Number261313

Location1205 North Missouri StMacon, MO 63552 · Macon County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63501 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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 9

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

8 suppliers38 claims74 services$6.23 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

3 suppliers15 claims15 services$45.31 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

4 suppliers17 claims17 services$69.03 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

6 suppliers16 claims16 services$22.12 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers21 claims102 services$2.94 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers17 claims17 services$21.28 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 17

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

BROOKE APRIL SPRAGUE FNP-C

Nurse Practitioner (Family)