Matthew Petersen, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

10425 Huffmeister Rd Ste 320
Houston, TX 77065-3429

Phone

(281) 955-2650

Fax

(281) 955-5875

NPI assigned

Jul 19, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare Kingwood Hospital, Kingwood, TX, CCN 450775

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.petersen.1@15533.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ortholonestar, PLLC

  • Orthopaedic Surgery Physician
  • Houston, TX
  • NPI 1942860176
  Medicare reassignment Care Compare group NPD
• Ortholonestar, PLLC

  • Orthopaedic Surgery Physician
  • Tomball, TX
  • NPI 1073475679
  NPD
• Cypress Surgical Services, PLLC

  • Surgical Physician Assistant
  • Houston, TX
  • NPI 1932618675
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• KPH-Consolidation, Inc.

  • General Acute Care Hospital
  • Kingwood, TX
  • NPI 1811942238
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1053764639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-664-2107",
            "fax_number": "281-955-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 HUFFMEISTER RD STE 320",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653429",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22485 Tomball Pkwy Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770701560",
            "country_code": "US",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Walker Petersen, MD
• Erik Thomas Petersen, M.D.
• Hannah Louise Petersen
• Laura A. Petersen, MD
• Margeaux Epner Petersen, MD
• Pamela Carol Petersen, M.D.
• Russell Scott Petersen Jr., DO
• Sara Petersen, MD
• Teresa F Petersen, LCSW
• Peterson Dna Testing

• Surgical Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.