Matthew D Peterson, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2390-24 Issued in WI

Practice address

6630 University Ave
Middleton, WI 53562-3036

Phone

(608) 263-8412

NPI assigned

Jul 24, 2006

Last updated

Mar 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1063434884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 UNIVERSITY AVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 UNIVERSITY AVE",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623036",
            "telephone_number": "608-263-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "2390-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT ORTHOPEDICS",
            "identifier": "2390-24",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob L Perlman
• Sean Paul Peronto, PA
• Kelly Peroutka, RN
• Rachel Petersen, MS, CCC-SLP
• Gloria Peterson, RN
• Emily Petranek, OT
• Lisa Ann Phillips, DPT
• Physical Medicine Rehabilitation Independent Services, SC
• Emilie Pinkovitz, LCSW
• Julia Pitz

• Orthopedic Physical Therapist in Middleton, WI
• Providers in Middleton, WI by specialty
• Orthopedic Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.