Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jacob Edward Peterson, MD, MBA

Individual provider General Practice Physician · NPI 1295196384

Dr. Jacob Edward Peterson, MD, MBA is an Internal Medicine in Norwich, Connecticut. Qualified in 2012, 14 years ago. Works from 3 locations and accepts Medicare assignment. Licensed in Connecticut and Virginia.

Years since qualifying
14
Licensed in
CT, VA
In the registry since
2016
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

79 Wawecus St Ste 103
Norwich, CT 06360-2173
Phone: (860) 886-1862
Fax: (860) 886-2046
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 20 York St, New Haven, CT 06510-3220 — (203) 688-4242
  • 600 Gresham Dr Fl 5, Norfolk, VA 23507-1904 — (757) 388-3198

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X · Licence 76208 (CT)
General Practice Physician Taxonomy 208D00000X · Licence 0101263068 (VA)
Hospitalist Physician Taxonomy 208M00000X · Licence 0101263068 (VA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 76208 (CT)
Internal Medicine Physician Taxonomy 207R00000X · Licence 0101263068 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1295196384
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MBA
Sole proprietorNo
NPI enumeratedMarch 16, 2016
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesPULMONARY DISEASE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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