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

Mr. Mark A Peterson, PA-C

Individual provider Physician Assistant · NPI 1740397140

Mr. Mark A Peterson, PA-C is a Physician Assistant in Kenosha, Wisconsin. Qualified in 1989, 37 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group. Licensed in Wisconsin.

Years since qualifying
37
Licensed in
WI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

7540 22nd Ave
Kenosha, WI 53143
Phone: (262) 656-7800
Fax: (262) 656-7810
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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 575-023 (WI)

Record details

NPI number1740397140
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 23, 2006
Last updated in NPPESApril 18, 2024
Certification dateApril 18, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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