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

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: October 25, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mark Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Healthpoint
1,036 mi
Federally Qualified Health Center (FQHC)
126 AUBURN AVE, SUITE 300
Auburn, WA 98002
  • Reassigned Medicare billing, Washington enrollment
  • 403 clinicians in this Medicare group
NPI 1730186966 (253) 735-0166
Public Hospital Dist No 1 Skagit
1,070 mi
Rural Health
1190 RIDDLE STREET
Darrington, WA 98241
  • Reassigned Medicare billing, Washington enrollment
  • 463 clinicians in this Medicare group
NPI 1013064575 (360) 436-1055

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-6215
DR. CHRISTIAN JAY THOMPSON O.D., F.A.A.O.
Optometrist
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 245-3732
LAURA ANN THOMAS R.N.
Registered Nurse
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-4646
MS. DANIELLE ROSE NATSEWAY R.N.
Registered Nurse
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-4646
BENJAMIN MILANOWSKI RN
Registered Nurse (Ambulatory Care)
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-6230
FRANCIS B ARMAO MD
Family Medicine
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-4646
DR. WILLIAM DANIEL LASTER PHARMD
Pharmacist
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-6118
DR. REGINA ELIZABETH ROSS MD
Family Medicine
500 INDIANA AVE
WINSLOW, AZ 86047
Navajo County (928) 289-4646

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Mark Peterson located?

Mark Peterson practices at 500 Indiana Ave, Winslow, AZ 86047. The listed phone number is (928) 289-4646.

What is Mark Peterson's specialty?

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

Is Mark Peterson enrolled in Medicare?

Yes. Mark Peterson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mark Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Peterson reassigns Medicare benefits to 2 organizations: Healthpoint (Auburn, WA) and Public Hospital Dist No 1 Skagit (Darrington, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

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.