Jacob R. Peterson, AA
NPI 1235249442ActiveIndividual· Anesthesiologist Assistant· La Crosse, WI
Anesthesiologist Assistant (AA) with Gundersen Lutheran Medical Center Inc, practicing in La Crosse, Wisconsin. Medicare paid $6,048 for services to 64 patients in 2024. Lists Gundersen Lutheran Medical Center as a hospital affiliation.
Overview
| NPI | 1235249442 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | AA |
| Sole proprietor | No |
| NPI issued | Aug 30, 2006 |
| Last updated in NPPES | Mar 22, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiologist Assistant Primary | 367H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Anesthesiology Assistant (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 64 |
|---|---|
| Services billed | 64 across 33 procedure codes |
| Paid by Medicare | $6,048 |
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Anesthesiology Assistant |
Medical group
- Gundersen Lutheran Medical Center IncLa Crosse, WI · 895 clinicians
Hospital affiliation
- Gundersen Lutheran Medical CenterLa Crosse, WI
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All 24 Anesthesiologist Assistant providers in La Crosse · All Anesthesiologist Assistant providers in Wisconsin