KELSEY PETERSON – Occupational Therapist, NPI 1730604802

KELSEY PETERSON is a healthcare provider. based in Bay city, Michigan. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 5201013406 (MI). The NPI Number for KELSEY PETERSON is 1730604802

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY PETERSON
NPI
1730604802
Phone
(989) 450-3341
Address
804 N Water St
Enumeration Date
9 August 2017
Last Update Date
8 December 2025

Doctor Profile

Medical School Name
SAGINAW VALLEY MEDICAL COLLEGE - NLG
Secondary Phone
9892724500
Graduation Year
2022 (4 years ago)
PAC ID
9234595893
Group Practice PAC ID
4183850266
Professional Enrollment ID
I20230524001161
Address ID
MI487229668BR5460XDRXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Digital endpointsOther names

711 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MI

Provider Addresses for KELSEY PETERSON

  • 804 N Water St

    Bay City, MI 487085620

    Phone: (989) 450-3341

    Type: Location

  • 41521, West 11 Mile Road, Novi, Oakland County, Michigan, 48375, United States

    NOVI, MI 483751803

    Phone: (248) 299-0030

    Type: Location

  • 804 N WATER ST

    BAY CITY, MI 487085620

    Phone: (989) 450-3341

    Type: Location

  • 5460 W ROLLING HILLS DR

    BRIDGEPORT, MI 487229668

    Phone: (989) 272-4500

    Fax: (989) 272-4501

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-05-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230524001161IOccupational Therapist In Private PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48708)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4183850266View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeWI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI

Reviews

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Frequently asked questions

Is there an official ID for KELSEY PETERSON in U.S. healthcare records?
The official identifier for KELSEY PETERSON is NPI 1730604802.
Is there an active status for KELSEY PETERSON?
For scheduling context, KELSEY PETERSON is shown as active in the registry.
What clinical focus is listed for KELSEY PETERSON?
At a glance, KELSEY PETERSON is tied to Occupational Therapist. Clinical services aligned with this taxonomy classification.
Is KELSEY PETERSON associated with Bay City?
Public fields place KELSEY PETERSON around Bay City, Michigan. Always confirm the exact site before visiting.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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