Kevin Peterson, DO is a medicare enrolled "Anesthesiology - Pain Medicine" physician in Jbsa-fort Sam Houston, Texas. His current practice location is
3551 Rodger Brooke Dr, Jbsa-fort Sam Houston, Texas. You can reach out to his office (for appointments etc.) via phone at
(210) 916-8666.
Kevin Peterson is licensed to practice in Texas (license number S0534) 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 1790225662.
Physician's Profile
Full Name | Kevin Peterson |
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Gender | Male |
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Speciality | Anesthesiology - Pain Medicine |
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Location | 3551 Rodger Brooke Dr, Jbsa-fort Sam Houston, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790225662
- Provider Enumeration Date: 02/27/2017
- Last Update Date: 06/17/2022
Medicare PECOS Information:
- PECOS PAC ID: 6800322520
- Enrollment ID: I20241204004643
Medical Identifiers
Medical identifiers for Kevin Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790225662 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207L00000X | Anesthesiology | S0534 (Texas) | Secondary |
208D00000X | General Practice | S0534 (Texas) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | S0534 (Texas) | 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 Peterson allows following entities to bill medicare on his behalf.
Entity Name | Austin Anesthesiology Group Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598724304 PECOS PAC ID: 0547256497 Enrollment ID: O20040424000086 |
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Entity Name | Lone Star Anesthesia Partners Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1124760996 PECOS PAC ID: 4880072636 Enrollment ID: O20220607000810 |
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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 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 Peterson, DO 3551 Rodger Brooke Dr, Anesthesia Residency, Jbsa-fort Sam Houston, TX 78234-4504 Ph: (210) 916-8666 | Kevin Peterson, DO 3551 Rodger Brooke Dr, Jbsa-fort Sam Houston, TX 78234-4504 Ph: (210) 916-8666 |
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