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

Dr. Mark Irwin Petersen, MD

Individual provider Internal Medicine Physician · NPI 1881647543

Dr. Mark Irwin Petersen, MD is an Internal Medicine in Tonganoxie, Kansas. Graduated from University of Kansas School of Med (KC/WICH/SAL) in 1984, 42 years ago. Practices with Mid America Senior Management ACO LLC, a 3-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
42
Trained at
University of Kansas School of Med (KC/WICH/SAL)
Licensed in
KS
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

21107 Donahoo Rd
Tonganoxie, KS 66086-4153
Phone: (913) 742-4084
Fax: (913) 742-4086
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 0421601 (KS)
Internal Medicine Physician Taxonomy 207R00000X · Licence 04-21601 (KS)

Record details

NPI number1881647543
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 17, 2006
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024
Mailing addressPo Box 996, Tonganoxie, KS 66086-0996

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolUNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated 1984 (42 years in practice)
Group practice Mid America Senior Management Aco Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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