MR. MARK A PETERSON PA-C
NPI 1740397140
Physician Assistant in Kenosha, WI

Q: What is Mark Peterson's NPI number?

The NPI number for Mark Peterson is 1740397140. It was assigned to this individual provider in the NPPES registry on August 23, 2006.

Q: What is Mark Peterson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Peterson was last updated on April 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 August 23, 2006PECOS Enrolled

7540 22ND AVE, KENOSHA, WI 53143(262) 656-7800(262) 656-7810 Get Directions Write a Review

NPPES record last updated: April 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 18, 2024, Mar 7, 2023, Nov 30, 2021 (3 updates tracked since 2021).

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About Mr. Mark A Peterson Pa-c NPPES

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

MR. MARK A PETERSON PA-C (NPI 1740397140) is an individual physician assistant in Kenosha, Wisconsin, licensed in Wisconsin (575-023) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Other (1989).

NPPES Registry Identity

NPI1740397140

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. MARK A PETERSONCredential: PA-C

Location Address7540 22ND AVEKenosha, WI 53143

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(262) 656-7800

Fax(262) 656-7810

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateAugust 23, 2006

Last NPPES UpdateApril 18, 20243 updates tracked since enumeration

NPPES CertifiedApril 18, 2024

✔ NPI 1740397140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 575-023

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

7540 22ND AVE, Kenosha, WI 53143

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Other Identifiers 1

Medicaid42924400WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Mark A Peterson Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1355478017

PECOS Enrollment IDI20100428000939

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

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.

325 services170 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

269 services191 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

168 services168 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

50 services48 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

48 services47 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

35 services33 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Aurora Memorial Hospital Burlington

Acute Care Hospitals · Burlington, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520059

Location252 Mchenry StBurlington, WI 53105 · Racine County

Emergency services

Aurora Medical Center Kenosha

Acute Care Hospitals · Kenosha, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520189

Location10400 75th StKenosha, WI 53142 · Kenosha County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53143 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

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

Referred Medical Equipment & Supplies CMS DME claims 18

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers28 claims70 services$5.60 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604