MR. TODD J PETERSEN (PA-C) – Physician Assistant, NPI 1740270537
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. TODD J PETERSEN (PA-C)
775 ENGINEERING AVE
SPRINGFIELD, IL 627035909
Phone: (217) 528-7541
Type: Location
1025, South 6th Street, South Town, Springfield, Sangamon County, Illinois, 62703, United States
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Type: Mailing
6854 PARKER RD
FLORISSANT, MO 630335313
Phone: (314) 286-6988
Fax: (314) 868-2561
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-05-13
PECOS data refreshed: 2026-05-27
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62703)
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