William J Petersen, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

294 Issued in WI

Practice address

2409 Center Ave
Madison, WI 53704-5628

Phone

(000) 000-0000

NPI assigned

Mar 2, 2006

Last updated

May 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Cross Plains, WI
  • NPI 1174583363
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1073580569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 CENTER AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CENTER AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045628",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Amanda Peters, MS, OTR
• Sophie Peters
• Allison L Petersen, PA-C
• Jane M Petersen, LCSW
• Maya Petersen
• Kim L Petershack, CD
• Kalie Peterson-Selle, RN
• Amy Lynn Hering Peterson, M.D.
• Andrea Peterson, RN
• Andrew D Peterson, LMFT

• Medical Physician Assistant in Madison, WI
• Providers in Madison, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.