Healthcare Provider Details

I. General information

NPI: 1144282120
Provider Name (Legal Business Name): PETER J MASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S HAMILTON ST UNIT 501
MADISON WI
53703-4186
US

IV. Provider business mailing address

350 S HAMILTON ST UNIT 501
MADISON WI
53703-4186
US

V. Phone/Fax

Practice location:
  • Phone: 608-443-8931
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number49077
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number49077
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number49077-020
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number2025-02756
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number49077
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: