Jacob R Peterson, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Aug 30, 2006

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

Enrolled in WI

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

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.

• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment Care Compare group NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Community/Retail Pharmacy
  • La Crosse, WI
  • NPI 1548710627
  NPD
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD
• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD

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

• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1790646719

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc.

  • Air Ambulance
  • La Crosse, WI
  • NPI 1467468173

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Winona, MN
  • NPI 1952959603

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1235249442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JACOB",
        "middle_name": "R",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brynn Peterson, OD
• Dianne L. Peterson, BSW
• Emily Elizabeth Peterson, PA
• Greggory Lyle Peterson, MD
• Harry J Peterson, MA
• Jaime M Peterson, PA
• Jessica Jean Peterson, CRNA
• Kathy J Peterson, PHYSICAL THERAPY ASS
• Laura Alice Peterson, MD
• Laura K Peterson

• Anesthesiologist Assistant in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Anesthesiologist Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.