Mark Gordon Peterson, MD
NPI 1629129168ActiveIndividual· Family Medicine· Winslow, AZ
Family Medicine (MD) in Winslow, Arizona, licensed in AK, with an NPI issued in January 2007. Enrolled in Medicare as practitioner - family practice.
Overview
| NPI | 1629129168 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Jan 12, 2007 |
| Last updated in NPPES | May 23, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 2304 | AK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Family Practice (WA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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