Doctor profile · Federal record
Dr. Kenneth Peterson, OD
Optometrist (CMS: Optometry) · Pismo Beach, CA
- NPI 1871565788
- Accepts Medicare
- MIPS 0.0 / 100 · 2023
- 28 yrs in practice
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
911 Oak Park Blvd Ste 104
Pismo Beach, CA 934493406
(805) 473-9393
fax (805) 473-1974
Credentials & registration
- NPI registered
- February 2006 — 20 yrs on file
- Profile last updated
- February 6, 2008
- Year of graduation
- 1998 — 28 yrs since
- Specialty taxonomy
- 152W00000X — NUCC code
- State license (1)
- California #9884T
- Medicaid
- CA #SD0098840
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1871565788. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
1,217
Distinct HCPCS
10
Medicare allowed
$103,122
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
92250 |
Photography of the retina | 428 | 370 | $40 | |
92014 |
Established patient complete exam of visual system | 334 | 333 | $134 | |
92012 |
Established patient problem focused exam of visual system | 195 | 145 | $96 | |
92004 |
New patient complete exam of visual system | 69 | 69 | $158 | |
99212 |
Established patient office or other outpatient visit, 10-19 minutes | 62 | 38 | $49 | |
92083 |
Exam of visual field with extended testing | 40 | 30 | $67 | |
66984 |
Removal of cataract with insertion of prosthetic lens | 24 | 16 | $111 | |
67820 |
Removal of eyelashes using forceps | 20 | 13 | $20 | |
92100 |
Multiple measurements of eye fluid pressure over an extended time period | 19 | 19 | $92 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 14 | 13 | $79 |
In context: peer comparison
Among 3 peers in Pismo Beach Optometrist, average services per provider: 94. This provider delivers 13× the peer median.Open Payments
Industry payments received
All-time total
$131
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Alcon Vision LLC | 1 | $130.84 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
69
Patients
14
Total drug cost
$1,608
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Latanoprost | Generic | 57 | 14 | $1,213 |
| Tobramycin-Dexamethasone (Tobramycin/Dexamethasone) | Brand | 12 | 0 | $395 |
Frequently asked questions
What is Dr. Kenneth Peterson's medical specialty?
Dr. Kenneth Peterson practices Optometrist in Pismo Beach, CA.
Where does Dr. Kenneth Peterson practice?
Dr. Kenneth Peterson practices at 911 Oak Park Blvd Ste 104, Pismo Beach, CA 934493406. Office phone: 8054739393.
What is Dr. Kenneth Peterson's NPI?
Dr. Kenneth Peterson's National Provider Identifier (NPI) is 1871565788, issued by NPPES.
Does Dr. Kenneth Peterson accept Medicare assignment?
Yes. Dr. Kenneth Peterson accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Kenneth Peterson commonly perform?
Top Medicare-reported procedures in 2023: Photography of the retina (HCPCS 92250); Established patient complete exam of visual system (HCPCS 92014); Established patient problem focused exam of visual system (HCPCS 92012). Source: CMS Medicare Physician & Other Practitioners file.