Mark Alan Petersen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A97116 Issued in CA

Practice address

533 Parnassus Ave RM U-503
San Francisco, CA 94143-0734

Phone

(415) 476-1888

Fax

(415) 476-6679

NPI assigned

Sep 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetersen13897@direct-ucsfmedicalcenter.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.

• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment NPD
• UCSF Pediatrics Associates

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1376614016
  Medicare reassignment NPD
• University of California San Francisco

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• University of California SFGH Medical Group

  • Otolaryngology Physician
  • San Francisco, CA
  • NPI 1154396208
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1164512851

  Pediatrics

  NPD
• University of California San Francisco

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD
• University of California SFGH Medical Group

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California SFGH Medical Group

  • Medical Toxicology (Emergency Medicine) Physician
  • San Francisco, CA
  • NPI 1730434333
  NPD
• University of California San Francisco

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Francisco, CA
  • NPI 1992818256
  NPD (past)
• University of California San Francisco Medical Center

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1144325440
  NPD (past)

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1780871160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 PARNASSUS AVE RM U-503",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430734",
            "telephone_number": "415-476-1888",
            "fax_number": "415-476-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 PARNASSUS AVE RM U-503",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941430734",
            "telephone_number": "415-476-1888",
            "fax_number": "415-476-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Potrero Ave.",
            "address_2": "Bldg. 5, #6M",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94110",
            "country_code": "US",
            "telephone_number": "628-206-8361",
            "fax_number": "628-206-3686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A97116",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmine S Peters
• Benjamin Paul Petersen
• Dana Kristopher Petersen, MD
• Heather Petersen, DPT
• Karla Melissa Petersen, M.D.
• Vagn Petersen, MS, NP
• Alissa Marie Peterson, M.D.
• Amy Hope Peterson, MFT
• Andrew Nelson Peterson
• Anja Peterson

• Pediatrics Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.