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MR. KEVIN WARREN PETERSON CRNA
NPI 1912971581
Nurse Anesthetist, Certified Registered in Marshall, MN

Active since February 13, 2006PECOS EnrolledAccepts Medicare Assignment
300 S BRUCE ST, MARSHALL, MN 56258(507) 532-9661 Get Directions Write a Review

NPPES record last updated: September 10, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 10, 2019, Aug 5, 2019, Aug 2, 2019 (3 updates tracked since 2019).

About Mr. Kevin Warren Peterson Crna NPPES

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

MR. KEVIN WARREN PETERSON CRNA (NPI 1912971581) is an individual nurse anesthetist, certified registered in Marshall, Minnesota, licensed in Minnesota (R-16439-8) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Madison Regional Health System, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1912971581
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. KEVIN WARREN PETERSONCredential: CRNA
Location Address300 S BRUCE STMarshall, MN 56258-1934
Mailing Address3267 230th AveGhent, MN 56239-1104 · (507) 828-4525
Phone(507) 532-9661
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateFebruary 13, 2006
Last NPPES UpdateSeptember 10, 20193 updates tracked since enumeration
✔ NPI 1912971581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MN · R-16439-8
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
300 S BRUCE ST, Marshall, MN 56258
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Secondary Practice Locations 2

Location 13267 230th AveGhent, MN 56239-1104 · Phone (507) 828-4525
Location 210 4th Ave SEGlenwood, MN 56334-1820 · Phone (320) 634-4521 ext. 2300

Other Identifiers 1

Medicaid026667100MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Oscar Insurance Company.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

Mr. Kevin Warren Peterson Crna 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 ID7719954270
PECOS Enrollment IDI20190405002253
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 Reassignments

9

Medicare enrollment records show Kevin Peterson reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Avera Marshall
Same address
Critical Access
300 S BRUCE ST
Marshall, MN 56258
  • Reassigned Medicare billing, Minnesota enrollment
  • 260 clinicians in this Medicare group
NPI 1568401016 (507) 532-9661
Southwest Minnesota Surgical Center, Inc.
0.8 mi
Ambulatory Surgical
1401 NWAKAMA ST, SUITE 400
Marshall, MN 56258
  • Reassigned Medicare billing, Minnesota enrollment
  • 11 clinicians in this Medicare group
NPI 1407023161 (507) 929-7696
Avera Granite Falls
27 mi
Family Medicine
345 10TH AVE
Granite Falls, MN 56241
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1700429610 (Minnesota)
  • 82 clinicians in this Medicare group
NPI 1700429644 (320) 564-3111
County Of Murray
31 mi
Clinic/Center
2040 JUNIPER AVE
Slayton, MN 56172
  • Reassigned Medicare billing, Minnesota enrollment
  • 36 clinicians in this Medicare group
NPI 1679565287 (507) 836-6153
Pipestone County Medical Center
42 mi
Critical Access
916 4TH AVE SW
Pipestone, MN 56164
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1073576906 (Minnesota)
  • 68 clinicians in this Medicare group
NPI 1598751240 (507) 825-5811
Family Surgery Center, LLC
57 mi
Ambulatory Surgical
1801 19TH AVE SW
Willmar, MN 56201
  • Reassigned Medicare billing, Minnesota enrollment
  • 7 clinicians in this Medicare group
NPI 1831200120 (320) 235-7700
Madison Community Hospital
74 mi
Critical Access
323 SW 10TH ST
Madison, SD 57042
  • Reassigned Medicare billing, South Dakota enrollment
  • 84 clinicians in this Medicare group
NPI 1588644058 (605) 256-6551
Glacial Ridge Hospital District
79 mi
Family Medicine
111 PLEASANT AVENUE
Brooten, MN 56316
  • Reassigned Medicare billing, Minnesota enrollment
  • Also billed through NPI 1538178520 (Minnesota)
  • 111 clinicians in this Medicare group
NPI 1255348223 (320) 346-2272
Avera St. Mary's
226 mi
Physical Therapist
1211 E WELLS AVE
Pierre, SD 57501
  • Reassigned Medicare billing, South Dakota enrollment
  • Medicare enrollment name: Avera St Marys
  • 197 clinicians in this Medicare group
NPI 1972082683 (605) 224-3100

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

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

Madison Regional Health System

Critical Access Hospitals · Madison, SD
OwnershipVoluntary non-profit - Private
CMS Certification Number431300
Location323 SW 10th StMadison, SD 57042 · Lake County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56258 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
$127.61 typical visit price
range $56.00 – $168.28
Typical copayment $31.90 (range $14.00 – $42.07)
Most-billed visit code 99204
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

JULIJANA BOTIC M.D.
Internal Medicine
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 537-9007
MISS KATE MARIE HEGNA PA-C
Physician Assistant
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 532-9661
TAYLOR RENEE KOR
Physician Assistant
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 532-9661
AVERA MARSHALL
Home Health
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 537-7070
LUCKY VANG D.O.
Surgery
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 532-9661
MICHAEL JOHN GOBLISH
Nurse Practitioner (Psychiatric/Mental Health)
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 337-2923
DR. DANIEL LISTER M.D.
Orthopaedic Surgery
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 532-9661
SARA LYNN KRAFT PNP
Nurse Practitioner (Pediatrics)
300 S BRUCE ST
MARSHALL, MN 56258
Lyon County (507) 537-9007

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 Kevin Peterson's NPI number?

The NPI number for Kevin Peterson is 1912971581. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Kevin Peterson located?

Kevin Peterson practices at 300 S Bruce St, Marshall, MN 56258. The listed phone number is (507) 532-9661.

What is Kevin Peterson's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Kevin Peterson enrolled in Medicare?

Yes. Kevin Peterson 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 Kevin Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Peterson reassigns Medicare benefits to 9 organizations: Avera Marshall (Marshall, MN), Southwest Minnesota Surgical Center, Inc. (Marshall, MN), Avera Granite Falls (Granite Falls, MN), County Of Murray (Slayton, MN), Pipestone County Medical Center (Pipestone, MN) and 4 more organizations, listed in the Medicare section above. 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 Kevin Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Peterson accept?

Health plans from Avera Health Plans and Oscar Insurance Company list Kevin Peterson 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 Kevin Peterson affiliated with any hospitals?

According to CMS data, Kevin Peterson is affiliated with Madison Regional Health System.

When was this NPI record last updated?

The NPPES record for Kevin Peterson was last updated on September 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.