KIMBERLY PETERSEN – Family Medicine Physician, NPI 1043247877
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,075 FAMILY PRACTICE in MN
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Provider Addresses for KIMBERLY PETERSEN
2810, Nicollet Avenue, Whittier, Minneapolis, Hennepin County, Minnesota, 55408, United States
MINNEAPOLIS, MN 554084708
Phone: (612) 873-6963
Type: Location
PO BOX 5074
SIOUX FALLS, SD 571175074
Phone:
Type: Mailing
1000 CONEY ST W
PERHAM, MN 565732102
Phone: (218) 347-1200
Type: Location
Park Av, 701, Park Avenue South, Minneapolis, Hennepin County, Minnesota, 55415, United States
MINNEAPOLIS, MN 554151623
Phone:
Type: Mailing
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: 2010-12-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101207001376 | I | Family Practice | MN | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 98 | 32 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 37 | 30 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 19 | 18 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 55408)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | NY | |
| Nurse Practitioner | ND | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Family Practice | MN | |
| General Surgery | ND | |
| Family Practice | GA | |
| Family Practice | MN | |
| Family Practice | ND | |
| Family Practice | ID | |
| Family Practice | MN |
Reviews
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