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

Individual provider Anesthesiologist Assistant · NPI 1235249442

Jacob R Peterson, AA is an Anesthesiology Assistant in LA Crosse, Wisconsin. Qualified in 2006, 20 years ago. Practices with Gundersen Lutheran Medical Center Inc, a 896-clinician group and accepts Medicare assignment.

Years since qualifying
20
In the registry since
2006
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Practice location Address checks out

1836 S Ave
LA Crosse, WI 54601-5429
Phone: (608) 782-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1235249442
Entity typeIndividual (Type 1)
GenderMale
Credentials AA
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESMarch 22, 2016
Mailing address1836 South Ave, La Crosse, WI 54601-5429

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Gundersen Lutheran Medical Center Inc — 896 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in LA Crosse