| Dr Mark Irwin Petersen, MD | |
|
21107 Donahoo Rd, Tonganoxie, KS 66086-4153 | |
| (913) 742-4084 | |
| (913) 742-4086 |
| Full Name | Dr Mark Irwin Petersen |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 42 Years |
| Location | 21107 Donahoo Rd, Tonganoxie, Kansas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881647543 | NPI | - | NPPES |
| 2050317102 | Other | RAILROAD MEDICARE | |
| 100135660B | Medicaid | KS | |
| 13217089 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 04-21601 (Kansas) | Secondary |
| 207R00000X | Internal Medicine | 0421601 (Kansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Encompass Health Home Health | Lenexa, KS | Home health agency |
| Caregivers Home Health | Topeka, KS | Home health agency |
| Faith Home Healthcare, Inc | Kansas city, KS | Home health agency |
| Interim Healthcare Of Kansas City | Overland park, KS | Home health agency |
| Ahc Home Health Of Kansas City, Llc | Overland park, KS | Home health agency |
| Phoenix Home Care And Hospice | Overland park, KS | Hospice |
| Catholic Comm Hospice | Overland park, KS | Hospice |
| Care Alternatives Of Kansas | Overland park, KS | Hospice |
| Stormont Vail Hospital | Topeka, KS | Hospital |
| St Lukes Hospital Of Kansas City | Kansas city, MO | Hospital |
| Adventhealth Ottawa | Ottawa, KS | Hospital |
| Providence Medical Center | Kansas city, KS | Hospital |
| Louisburg Healthcare & Rehab Center | Louisburg, KS | Nursing home |
| Eskridge Care And Rehab | Eskridge, KS | Nursing home |
| Lansing Care And Rehab | Lansing, KS | Nursing home |
| Edwardsville Care And Rehab | Edwardsville, KS | Nursing home |
| Parkway Operator Llc | Edwardsville, KS | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mid America Senior Management Aco Llc | 1456896190 | 3 |
| Theoria Medical | 5395098339 | 414 |
| Mid America Senior Management Llc | 6406827435 | 3 |
| Entity Name | Mid America Senior Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942356977 PECOS PAC ID: 6406827435 Enrollment ID: O20050707000856 |
| Entity Name | Hospitalist Medicine Physicians Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629307095 PECOS PAC ID: 3476688318 Enrollment ID: O20151112002441 |
| Entity Name | Mid America Senior Management Aco Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326888900 PECOS PAC ID: 1456896190 Enrollment ID: O20240717002639 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20240925002329 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Irwin Petersen, MD Po Box 996, Tonganoxie, KS 66086-0996 Ph: (913) 742-4084 | Dr Mark Irwin Petersen, MD 21107 Donahoo Rd, Tonganoxie, KS 66086-4153 Ph: (913) 742-4084 |