DR. KELSEY CARL PETERSON JR. M.D.
NPI 1033281019
Specialist in Huntington Beach, CA
NPI Status: Active since November 14, 2006
Contact Information
17742 BEACH BLVD
245
HUNTINGTON BEACH, CA
ZIP 92647
Phone: (714) 329-0179
Fax: (714) 965-0311
- Individual
- Male
- Specialist
- PECOS Enrolled
About KELSEY PETERSON
This page provides the complete NPI Profile along with additional information for Kelsey Peterson, a provider established in Huntington Beach, California with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1033281019 assigned on November 2006. The practitioner's primary taxonomy code is 174400000X with license number G17592 (CA). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1033281019
- Provider Name
- DR. KELSEY CARL PETERSON JR. M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 17742 BEACH BLVD 245 HUNTINGTON BEACH, CA 92647
- Location Phone
- (714) 329-0179
- Location Fax
- (714) 965-0311
- Mailing Address
- 20462 KENWORTH CIR HUNTINGTON BEACH, CA 92646
- Mailing Phone
- (714) 329-0179
- Mailing Fax
- (714) 965-0311
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-14-2006
- Last Update Date
- 03-15-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- G17592
- License State
- CA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Medicare Participation & PECOS Enrollment Status
Kelsey Peterson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 26 times for 13 patientsReviews for DR. KELSEY CARL PETERSON JR. M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 3 | 3 | 2 | 8 | 1 | 0 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 6 | 3 | 4 | 8 | 2 | 0 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 6 + 3 + 4 + 8 + 2 + 0 + 2 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1033281019 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124015888 | BASSIL AISH MD Individual | Family Medicine | 17742 BEACH BLVD STE 215 HUNTINGTON BEACH, CA 92647 (714) 848-1655 |
| 1396732053 | ARNOLD J BRENDER MD Individual | General Practice | 17742 BEACH BLVD STE 215 HUNTINGTON BEACH, CA 92647 (714) 848-1655 |
| 1366439200 | BEACH PHYSICIANS MEDICAL GROUP INC Organization | Family Medicine | 17742 BEACH BLVD STE 215 HUNTINGTON BEACH, CA 92647 (714) 848-1655 |
| 1700847704 | PATRICIA N STEPHENS M.D. Individual | Pediatrics (Adolescent Medicine) | 17742 BEACH BLVD SUITE 360 HUNTINGTON BEACH, CA 92647 (714) 848-0868 |
| 1225095631 | CAO VAN PHAM MD Individual | Internal Medicine (Cardiovascular Disease) | 17742 BEACH BLVD SUITE #230 HUNTINGTON BEACH, CA 92647 (714) 848-0032 |
| 1114985892 | DR. MARY ANNETTE COTE M.D. Individual | Ophthalmology | 17742 BEACH BLVD SUITE 305 HUNTINGTON BEACH, CA 92647 (714) 596-4488 |
| 1225081953 | DR. STEVE THUAN VU M.D Individual | Plastic Surgery | 17742 BEACH BLVD SUITE 335 HUNTINGTON BEACH, CA 92647 (714) 848-1133 |
| 1427086628 | DR. PAULINE PEPEK M.D. Individual | Pediatrics (Adolescent Medicine) | 17742 BEACH BLVD SUITE 240 HUNTINGTON BEACH, CA 92647 (714) 842-0444 |
| 1114018173 | VIPAL SONI M.D. Individual | Dermatology | 17742 BEACH BLVD SUITE #325 HUNTINGTON BEACH, CA 92647 (714) 848-0770 |
| 1780769554 | LEE S KIM Organization | Pharmacy (Community/Retail Pharmacy) | 17742 BEACH BLVD SUITE 100 HUNTINGTON BEACH, CA 92647 (714) 848-4447 |
| 1609902238 | LEE SUNG KIM PHARMACIST Individual | Pharmacist | 17742 BEACH BLVD SUITE 100 HUNTINGTON BEACH, CA 92647 (714) 848-4447 |
| 1477672673 | DR. ARASH ANTHONY RASSOULI D.D.S. Individual | Dentist (General Practice) | 17742 BEACH BLVD #350 HUNTINGTON BEACH, CA 92647 (714) 842-5561 |
| 1508034380 | MOSAIC SURGERY CENTER, LLC Organization | Clinic/Center (Ambulatory Surgical) | 17742 BEACH BLVD STE. #335 HUNTINGTON BEACH, CA 92647 (714) 848-1133 |
| 1831322403 | HSIN CHANG, CHAO SHUO HUANG MEDICAL GROUP INC. Organization | Pediatrics (Adolescent Medicine) | 17742 BEACH BLVD SUITE 240 HUNTINGTON BEACH, CA 92647 (714) 842-0444 |
| 1518289503 | CAO VAN PHAM M D INC Organization | Internal Medicine (Cardiovascular Disease) | 17742 BEACH BLVD SUITE #230 HUNTINGTON BEACH, CA 92647 (714) 848-0032 |
| 1962726331 | VIPAL SONI M.D., INC. Organization | Dermatology | 17742 BEACH BLVD SUITE 325 HUNTINGTON BEACH, CA 92647 (714) 848-0770 |
| 1689983330 | GLENDA B SECOR, OD, FAAO, INC Organization | Optometrist | 17742 BEACH BLVD 305 HUNTINGTON BEACH, CA 92647 (714) 596-4488 |
| 1164723284 | SURF CITY PEDS Organization | Pediatrics (Adolescent Medicine) | 17742 BEACH BLVD SUITE 240 HUNTINGTON BEACH, CA 92647 (714) 842-0444 |
| 1154745842 | PAUL ALAN REGGIARDO D.D.S. Individual | Dentist (Pediatric Dentistry) | 17742 BEACH BLVD SUITE 320 HUNTINGTON BEACH, CA 92647 (714) 848-0234 |
| 1871910265 | CLAUDINE YAMAOKA PNP Individual | Nurse Practitioner (Pediatrics) | 17742 BEACH BLVD #240 HUNTINGTON BEACH, CA 92647 (714) 842-0444 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1033281019, enumerated in the NPI registry as an "individual" on November 14, 2006
The provider is located at 17742 Beach Blvd 245 Huntington Beach, Ca 92647 and the phone number is (714) 329-0179
The provider's speciality is Specialist with taxonomy code 174400000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes.
This NPI record was last updated on November 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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