DR. KRISTINA SIU PETSAS (M.D.) – Family Medicine Physician, NPI 1003159948

DR. KRISTINA SIU PETSAS (M.D.) is a healthcare provider. based in Des moines, Washington. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 60674964 (WA). The NPI Number for DR. KRISTINA SIU PETSAS (M.D.) is 1003159948

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTINA SIU PETSAS (M.D.)
NPI
1003159948
Phone
(206) 212-4500
Address
2781 S 242ND ST
Enumeration Date
28 March 2013
Last Update Date
28 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2535963300
Graduation Year
2012 (14 years ago)
PAC ID
9133415011
Group Practice PAC ID
9032022579
Professional Enrollment ID
I20160831002340

Contacts

SOAP Endpoint
https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Other namesUpdated within 12 months

Provider Addresses for DR. KRISTINA SIU PETSAS (M.D.)

  • 2781 S 242ND ST

    DES MOINES, WA 981985166

    Phone: (206) 212-4500

    Type: Mailing

  • 2781 S 242nd St

    Des Moines, WA 981985166

    Phone: (206) 212-4500

    Type: Location

  • 209 MARTIN LUTHER KING JR WAY

    TACOMA, WA 984054265

    Phone: (253) 596-3300

    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: 2016-08-31

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
I20160831002340IGeneral PracticeWATBD

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 98198)

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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: 9032022579View full group profile

Reviews

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Frequently asked questions

Is DR. KRISTINA SIU PETSAS (M.D.) listed with a National Provider Identifier?
Yes — DR. KRISTINA SIU PETSAS (M.D.) has NPI 1003159948 on file in the registry.
Is DR. KRISTINA SIU PETSAS (M.D.) still an active registrant?
DR. KRISTINA SIU PETSAS (M.D.) carries an active NPI according to the public dataset.
What clinical focus is listed for DR. KRISTINA SIU PETSAS (M.D.)?
At a glance, DR. KRISTINA SIU PETSAS (M.D.) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. KRISTINA SIU PETSAS (M.D.) associated with Des Moines?
Public fields place DR. KRISTINA SIU PETSAS (M.D.) around Des Moines, Washington. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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