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

Individual provider Physician Assistant · NPI 1497005474

Gina Renee Peterson, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2012, 14 years ago. Practices with Saint Mary's Health Services, a 177-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

330 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1267
Phone: (616) 752-6235
Fax: (616) 328-8176
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601006479 (MI)

Record details

NPI number1497005474
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 17, 2012
Last updated in NPPESOctober 30, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Saint Mary'S Health Services — 177 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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