KYLE PETERSEN (MD) – Orthopaedic Surgery of the Spine Physician, NPI 1104280700
Orthopaedic Surgery of the Spine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,346 ORTHOPEDIC SURGERY in OH
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Provider Addresses for KYLE PETERSEN (MD)
Summa Health System – Akron Campus, 525, East Market Street, Arlington, Akron, Summit County, Ohio, 44304, United States
SUMMA HEALTH SYSTEM ORTHOPAEDIC SURGERY RESIDENCY
AKRON, OH 443041619
Phone:
Type: Mailing
4215 BURNS RD STE 200
PALM BEACH GARDENS, FL 334104625
Phone: (561) 694-7776
Type: Mailing
4215 BURNS RD STE 100
PALM BEACH GARDENS, FL 334104627
Phone: (561) 694-7776
Fax: (561) 694-3099
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $12,874.
Total Amount is formed as General ($12,874) + Research ($0) + Ownership ($0) = $12,874.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: SurGenTec ($12,000).
Total Amount
$12,874
General + Research + Ownership
Payments
18
Total payment records
General Amount
$12,874
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SurGenTec | $12,000 |
| Medtronic, Inc. | $299 |
| Alphatec Spine, Inc | $222 |
| Orthofix Medical, Inc. | $139 |
| Stryker Corporation | $120 |
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: 2022-06-10
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 |
|---|---|---|---|---|
| I20220610001812 | I | Orthopedic Surgery | FL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 344 | 252 | $0 |
| 72110 | X-ray of lower and sacral spine, minimum of 4 views | 202 | 198 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 177 | 177 | $0 |
| 72100 | X-ray of lower and sacral spine, 2-3 views | 95 | 85 | $0 |
| 72050 | X-ray of upper spine, 4-5 views | 94 | 93 | $0 |
Insurance plans in this area (ZIP 44304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Orthopedic Surgery, Hand Surgery | MI | |
| Physical Therapist In Private Practice | AL | |
| Orthopedic Surgery | FL | |
| Physical Therapist In Private Practice | FL | |
| Hand Surgery | FL | |
| P O D I A T R Y | FL | |
| Physician Assistant | FL | |
| Physical Therapist In Private Practice | FL | |
| Physical Medicine And Rehabilitation | FL |
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