Kevin W Peterson, DO is a medicare enrolled "Pediatrics" physician in Indianola, Iowa. His current practice location is
307 E Scenic Valley Ave, Indianola, Iowa. You can reach out to his office (for appointments etc.) via phone at
(515) 961-8448.
Kevin W Peterson is licensed to practice in Iowa (license number 4172) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1669633343.
Physician's Profile
| Full Name | Kevin W Peterson |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 307 E Scenic Valley Ave, Indianola, Iowa |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669633343
- Provider Enumeration Date: 06/24/2008
- Last Update Date: 10/29/2019
Medicare PECOS Information:
- PECOS PAC ID: 7719155795
- Enrollment ID: I20110718000544
Medical Identifiers
Medical identifiers for Kevin W Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669633343 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208M00000X | Hospitalist | DO-04172 (Iowa) | Secondary |
| 208000000X | Pediatrics | 4172 (Iowa) | Primary |
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. Kevin W Peterson allows following entities to bill medicare on his behalf.
| Entity Name | Mercy Clinics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457691941
PECOS PAC ID: 7911810882
Enrollment ID: O20031112000238 |
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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. Kevin W Peterson 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 |
|---|
Kevin W Peterson, DO
Po Box 1475,
Des Moines, IA 50305-1475
Ph: (515) 961-8448 | Kevin W Peterson, DO
307 E Scenic Valley Ave,
Indianola, IA 50125-4865
Ph: (515) 961-8448 |
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