Robert William Peterson, MD - Medicare Pediatrics in Portland, OR

Robert William Peterson, MD is a medicare enrolled "Pediatrics" physician in Portland, Oregon. His current practice location is 3550 N Interstate Ave, Kaiser Permanente Interstate Medical Office East, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 331-3078.

Robert William Peterson is licensed to practice in Oregon (license number 30984) 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 1104938380.

Contact Information

Robert William Peterson, MD
3550 N Interstate Ave, Kaiser Permanente Interstate Medical Office East,
Portland, OR 97227-1196
(503) 331-3078
Not Available

Map and Direction




Physician's Profile

Full NameRobert William Peterson
GenderMale
SpecialityPediatrics
Location3550 N Interstate Ave, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104938380
  • Provider Enumeration Date: 08/31/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 7012091077
  • Enrollment ID: I20080228000641

Medical Identifiers

Medical identifiers for Robert William Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104938380NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 30984 (Washington)Secondary
208000000XPediatrics 30984 (Oregon)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. Robert William Peterson allows following entities to bill medicare on his behalf.
Entity NameKaiser Foundation Health Plan Of The Northwest
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184786527
PECOS PAC ID: 5799688230
Enrollment ID: O20040130000799

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. Robert William 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 AddressPractice Location Address
Robert William Peterson, MD
3550 N Interstate Ave, Kaiser Permanente Interstate Medical Office East,
Portland, OR 97227-1196

Ph: () -
Robert William Peterson, MD
3550 N Interstate Ave, Kaiser Permanente Interstate Medical Office East,
Portland, OR 97227-1196

Ph: (503) 331-3078

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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