TYSEN J PETRE D.O.
NPI 1871642470
Family Medicine in Kirksville, MO
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
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
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
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.
Medicare Billing Reassignments
4Medicare enrollment records show Tysen Petre reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Kirksville, MO 63501
- Reassigned Medicare billing, Missouri enrollment
- 149 clinicians in this Medicare group
Kirksville, MO 63501
- Reassigned Medicare billing, Missouri enrollment
- 18 clinicians in this Medicare group
Kirksville, MO 63501
- Reassigned Medicare billing, Missouri enrollment
- 8 clinicians in this Medicare group
Macon, MO 63552
- Reassigned Medicare billing, Missouri enrollment
- Also billed through NPI 1548215106 (Missouri)
- 10 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, MOBoone Hospital Center
Acute Care Hospitals · Columbia, MOMoberly Regional Medical Center
Acute Care Hospitals · Moberly, MOPershing Memorial Hospital
Critical Access Hospitals · Brookfield, MOMacon County Samaritan Memorial Hospital
Critical Access Hospitals · Macon, MOPhysician 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.
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.
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.
KIRKSVILLE, MO 63501
KIRKSVILLE, MO 63501
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 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.
Where is Tysen Petre located?
Tysen Petre practices at 1611 S Baltimore St, Kirksville, MO 63501. The listed phone number is (660) 665-7575.
What is Tysen Petre's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Tysen Petre enrolled in Medicare?
Yes. Tysen Petre 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 organizations bill Medicare for Tysen Petre's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tysen Petre reassigns Medicare benefits to 4 organizations: Hannibal Regional Healthcare System, Inc (Kirksville, MO), A T Still University Of Health Sciences (Kirksville, MO), Kirksville Missouri Hospital Company, LLC (Kirksville, MO) and Macon County Samaritan Hospital (Macon, MO). Each 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 Tysen Petre's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tysen Petre accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 3 other insurers list Tysen Petre 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 Tysen Petre affiliated with any hospitals?
According to CMS data, Tysen Petre is affiliated with Northeast Regional Medical Center, Boone Hospital Center, Moberly Regional Medical Center, Pershing Memorial Hospital and Macon County Samaritan Memorial Hospital.
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 13 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.
# Tysen J Petre, D.O. · NPI 1871642470
Family Medicine physician in Kirksville, Missouri. Individual provider, active in the CMS NPPES registry since January 10, 2007.
## Identity
- **NPI:** 1871642470 (Entity type: Individual)
- **Enumerated:** January 10, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 2006004444 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 1611 S BALTIMORE ST, Kirksville, MO 63501-4518
- **Phone:** (660) 665-7575 · **Fax:** (660) 665-7576
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Hannibal Regional Healthcare System, Inc (NPI 1447789300, Kirksville, MO); A T Still University Of Health Sciences (NPI 1164484887, Kirksville, MO); Kirksville Missouri Hospital Company, LLC (NPI 1104899442, Kirksville, MO); Macon County Samaritan Hospital (NPI 1891734505, Macon, MO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** At Still University Of Health Sciences, College Of Osteo Med, Kirksville, class of 2004
## Record status
- **NPPES last updated:** September 16, 2025
- **Other identifiers:** Other BNDD (MO)
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Source: [NPI Profile](https://npiprofile.com/npi/1871642470) · Data from the CMS NPPES public registry.