Kenneth R Petersen, MD - Medicare Internal Medicine in Glendale, AZ

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Kenneth R Petersen, MD is a medicare enrolled "Internal Medicine" physician in Glendale, Arizona. He went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 1983 and has 43 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Banner Primary Care Physicians Arizona Llc, Bhsm Rehabilitation Llc and his current practice location is 7701 W Aspera Blvd, Glendale, Arizona. You can reach out to his office (for appointments etc.) via phone at (623) 465-6060.

Kenneth R Petersen is licensed to practice in Arizona (license number 64419) 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 1912017104.

Contact Information

Kenneth R Petersen, MD
7701 W Aspera Blvd,
Glendale, AZ 85308-7947
(623) 465-6060
(623) 242-5833

Map and Direction




Physician's Profile

Full NameKenneth R Petersen
GenderMale
SpecialityInternal Medicine
Experience43 Years
Location7701 W Aspera Blvd, Glendale, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kenneth R Petersen attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 1983
  NPI Data:
  • NPI Number: 1912017104
  • Provider Enumeration Date: 08/30/2006
  • Last Update Date: 10/01/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 3173571973
  • Enrollment ID: I20211129002333

Medical Identifiers

Medical identifiers for Kenneth R Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912017104NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 64419 (Arizona)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Banner Home Care-arizonaMesa, AZHome health agency

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Banner Primary Care Physicians Arizona Llc6406020155236
Bhsm Rehabilitation Llc2062773138450

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. Kenneth R Petersen allows following entities to bill medicare on his behalf.
Entity NameBanner Primary Care Physicians Arizona LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659640902
PECOS PAC ID: 6406020155
Enrollment ID: O20111115000898

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. Kenneth R 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
Kenneth R Petersen, MD
7701 W Aspera Blvd Ste 201,
Glendale, AZ 85308-7947

Ph: (623) 465-6060		Kenneth R Petersen, MD
7701 W Aspera Blvd,
Glendale, AZ 85308-7947

Ph: (623) 465-6060

Reviews and Comments


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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.