Keith E Petersen, DO - Medicare Family Medicine in Tacoma, WA

  1. Home
  2. Family Medicine
  3. WA
  4. Tacoma
Keith E Petersen, DO is a medicare enrolled "Family Medicine - Adult Medicine" physician in Tacoma, Washington. His current practice location is 9040 Jackson Ave, Tacoma, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 968-1340.

Keith E Petersen is licensed to practice in Washington (license number 60595760) 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 1356615470.

Contact Information

Keith E Petersen, DO
9040 Jackson Ave,
Tacoma, WA 98431-1000
(253) 968-1340
Not Available

Map and Direction




Physician's Profile

Full NameKeith E Petersen
GenderMale
SpecialityFamily Medicine - Adult Medicine
Location9040 Jackson Ave, Tacoma, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1356615470
  • Provider Enumeration Date: 03/07/2012
  • Last Update Date: 03/12/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0749592327
  • Enrollment ID: I20170529000058

Medical Identifiers

Medical identifiers for Keith E Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1356615470NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QA0505XFamily Medicine - Adult Medicine 60595760 (Washington)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. Keith E Petersen allows following entities to bill medicare on his behalf.
Entity NameKlickitat County Public Hospital District No1
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467530915
PECOS PAC ID: 0648164269
Enrollment ID: O20040212000690

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. Keith E 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 AddressPractice Location Address
Keith E Petersen, DO
9040 Jackson Ave 9040 Jackson Street,
Tacoma, WA 98431-1000

Ph: (253) 968-1340		Keith E Petersen, DO
9040 Jackson Ave,
Tacoma, WA 98431-1000

Ph: (253) 968-1340

Reviews and Comments


Family Medicine Doctors in Tacoma, WA

Dr. Kristina Siu Petsas, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405
Phone: 253-596-3300    
Mrs. Anne Garces Laporte, D.O.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405
Phone: 253-596-3300    
Dr. Charles Gilbert Childers, M.D.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 2624 S 38th St, Tacoma, WA 98409
Phone: 253-475-5908    Fax: 253-475-5958
James M Roos, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405
Phone: 253-403-1000    
Loren B Betteridge, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 3733 S Thompson Ave, Tacoma, WA 98418
Phone: 253-472-4473    Fax: 253-474-3056
Dr. Thuy-tien V Le, DO
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 732 Broadway Ste 201, Tacoma, WA 98402
Phone: 702-871-8535    Fax: 941-499-0035
Alexander K Lee, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405
Phone: 253-459-7785    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

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.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.