Mr Kevin Lee Petersen, LMHC in Rochester, MN - Medicare Clinical Psychologist Provider

Mr Kevin Lee Petersen, LMHC is a medicare enrolled "Psychologist - Clinical" provider in Rochester, Minnesota. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Nystrom And Associates Ltd and his current practice location is 401 16th St Se, Rochester, Minnesota. You can reach out to his office (for appointments etc.) via phone at (507) 315-4184.

Mr Kevin Lee Petersen is licensed to practice in Minnesota (license number LP6513) 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 1578759270.

Contact Information

	Mr Kevin Lee Petersen, LMHC
	401 16th St Se, Rochester, MN 55904-7973
	(507) 315-4184
	(507) 516-0031

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Kevin Lee Petersen
Gender	Male
Speciality	Clinical Psychologist
Experience	10 Years
Location	401 16th St Se, Rochester, Minnesota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Kevin Lee Petersen graduated from medical school in 2014

NPI Data:

NPI Number: 1578759270
Provider Enumeration Date: 09/18/2007
Last Update Date: 03/13/2020

Medicare PECOS Information:

PECOS PAC ID: 1951635788
Enrollment ID: I20200416000500

Medical Identifiers

Medical identifiers for Mr Kevin Lee Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578759270	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	LP6513 (Minnesota)	Primary
101YM0800X	Counselor - Mental Health	00399 (Iowa)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Nystrom And Associates Ltd	6406752492	309

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. Mr Kevin Lee Petersen allows following entities to bill medicare on his behalf.

Entity Name	Nystrom & Associates Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592

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. Mr Kevin Lee 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
Mr Kevin Lee Petersen, LMHC 401 16th St Se, Rochester, MN 55904-7973 Ph: (507) 315-4184	Mr Kevin Lee Petersen, LMHC 401 16th St Se, Rochester, MN 55904-7973 Ph: (507) 315-4184

Reviews and Comments

Psychologist in Rochester, MN

Jennifer L Kerkvliet, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511
Sarah Hancock-hall, MS, LPCC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511
Kristine Donovan, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511
Jeffrey Paul Clark, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1932 Viking Dr Nw, Rochester, MN 55901 Phone: 180-042-2016
Rachel Suzanne Wasson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-778-2342
Jane H Cerhan, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511
Abigail Laurie Matthews Hamberg, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 200 1st St Sw, Rochester, MN 55905 Phone: 507-284-2511 Fax: 513-636-3677

Mr Kevin Lee Petersen, LMHC - Medicare Psychologist in Rochester, MN