Dr Kenneth Wendell Petersen, DO is a medicare enrolled "Orthopaedic Surgery" physician in Harrisonville, Missouri. He went to R Franklin University Of Med & Sci/chicago Medical School and graduated in 1999 and has 25 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Cass Regional Medical Center and his current practice location is
2820 E Rock Haven Rd, Suite # 120, Harrisonville, Missouri. You can reach out to his office (for appointments etc.) via phone at
(816) 380-7662.
Dr Kenneth Wendell Petersen is licensed to practice in Missouri (license number 2013002819) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568637395.
Physician's Profile
| Full Name | Dr Kenneth Wendell Petersen |
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| Gender | Male |
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| Speciality | Orthopedic Surgery |
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| Experience | 25 Years |
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| Location | 2820 E Rock Haven Rd, Harrisonville, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kenneth Wendell Petersen attended and graduated from R Franklin University Of Med & Sci/chicago Medical School in 1999
NPI Data:
- NPI Number: 1568637395
- Provider Enumeration Date: 04/23/2008
- Last Update Date: 10/08/2014
Medicare PECOS Information:
- PECOS PAC ID: 5193899573
- Enrollment ID: I20130611000877
Medical Identifiers
Medical identifiers for Dr Kenneth Wendell Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568637395 | NPI | - | NPPES |
| 200570110A | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207X00000X | Orthopaedic Surgery | 05-33327 (Kansas) | Secondary |
| 207X00000X | Orthopaedic Surgery | 2013002819 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Cass Regional Medical Center | 7517853781 | 45 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kenneth Wendell Petersen allows following entities to bill medicare on his behalf.
| Entity Name | Cass Regional Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477535326
PECOS PAC ID: 7517853781
Enrollment ID: O20040225000028 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth Wendell Petersen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kenneth Wendell Petersen, DO
2800 E Rock Haven Rd,
Harrisonville, MO 64701-4411
Ph: (816) 380-3474 | Dr Kenneth Wendell Petersen, DO
2820 E Rock Haven Rd, Suite # 120,
Harrisonville, MO 64701-4411
Ph: (816) 380-7662 |
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