MR. KEVIN WARREN PETERSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1912971581
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN
Provider Addresses for MR. KEVIN WARREN PETERSON (CRNA)
3267 230th Ave
Ghent, MN 562391104
Phone: (507) 828-4525
Type: Location
10 4th Ave SE
Glenwood, MN 563341820
Phone: (320) 634-4521
Type: Location
Avera Marshall Regional Medical Center, 300, South Bruce Street, Marshall, Lyon County, Minnesota, 56283, United States
MARSHALL, MN 562581934
Phone: (507) 532-9661
Type: Location
3267 230TH AVE
GHENT, MN 562391104
Phone: (507) 828-4525
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $15.
Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.
Last reported payment date: 2023-03-23 • Largest payer in this snapshot: Medtronic, Inc. ($15).
Total Amount
$15
General + Research + Ownership
Payments
1
Total payment records
General Amount
$15
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $15 |
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: 2019-04-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20050112000041 | I | Certified Registered Nurse Anesthetist (Crna) | MN | TBD |
| I20190405002253 | I | Certified Registered Nurse Anesthetist (Crna) | SD | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56239)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | SD | |
| Diagnostic Radiology | SD | |
| Physician Assistant | SD | |
| Diagnostic Radiology | SD | |
| Physician Assistant | SD | |
| Diagnostic Radiology | SD | |
| Diagnostic Radiology | SD | |
| Diagnostic Radiology | SD | |
| Family Practice | SD | |
| - | SD |
Reviews
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