Anissa Peterson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011567 Issued in MI

Practice address

1111 Teneyck St Ste 100
Jackson, MI 49201-2493

Phone

(517) 205-8940

Fax

(517) 205-0108

NPI assigned

Aug 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Anissa Martinez Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org

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

• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group NPD
• Bronson Battle Creek Hospital

  • Internal Medicine Physician
  • Battle Creek, MI
  • NPI 1093119638

  Physician Assistant

  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1235676180
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• University of Detroit Mercy

  • General Practice Physician
  • Detroit, MI
  • NPI 1669187696
  NPD (past)
• Wa Foote Memorial Hospital, Inc

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1265487722

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1093434870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TENEYCK ST STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012493",
            "telephone_number": "517-205-8940",
            "fax_number": "517-205-0108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Capital Ave SW Ste 302",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490154187",
            "country_code": "US",
            "telephone_number": "269-979-6333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANISSA",
            "last_name": "MARTINEZ",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Perry Drug Stores Inc and Subsidiaries
• Michelle Perusse
• Tina M Pestun, AGACNP
• Debra Peters, LPN
• Susan Peters
• Christine Irene Peterson, LCMSW
• Holly Peterson
• Jodi Lynn Peterson, CPSS, PSP
• Pamela Teresa Peterson, NP
• Taylar Peterson

• Physician Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.