DR. MARK GORDON PETERSON MD
NPI 1629129168
Family Medicine in Winslow, AZ

Q: What is Mark Peterson's NPI number?

The NPI number for Mark Peterson is 1629129168. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Q: What is Mark Peterson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Peterson was last updated on May 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 12, 2007PECOS Enrolled

500 INDIANA AVE, WINSLOW, AZ 86047(928) 289-4646(928) 289-6229 Get Directions Write a Review

NPPES record last updated: May 23, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Mark Gordon Peterson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK GORDON PETERSON MD (NPI 1629129168) is an individual family medicine provider in Winslow, Arizona, licensed in Alaska (2304) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629129168

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. MARK GORDON PETERSONCredential: MD

Location Address500 INDIANA AVEWinslow, AZ 86047-2169

Mailing Address500 Indiana AveWinslow, AZ 86047-2169 · (928) 289-4646 · Fax (928) 289-6229

Phone(928) 289-4646

Fax(928) 289-6229

Sole ProprietorNo

Enumeration DateJanuary 12, 2007

Last NPPES UpdateMay 23, 2014

✔ NPI 1629129168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in AK · 2304

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

500 INDIANA AVE, Winslow, AZ 86047

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Other Identifiers 7

Medicare UPINA02073

Medicare ID-Type Unspecified8EC588AK

Medicare ID-Type Unspecified8EC589AK

MedicaidMD28841AK

Medicare ID-Type Unspecified8EZ93AAK

Medicare ID-Type Unspecified8EC587AK

Medicare ID-Type Unspecified8EC590AK

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mark Gordon Peterson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86047 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAI MAHESH PATEL PHARMD

Pharmacist (Pharmacotherapy)