Matthew Peterkin, SRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95002412 Issued in CA

Practice address

2101 N Waterman Ave
San Bernardino, CA 92404-4836

Phone

(909) 269-1947

NPI assigned

Jan 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Springs Anesthesia Services PCGroup PAC ID 6406049592, 90 clinicians

Darin Rentz DO PCGroup PAC ID 7315333853, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129
• Riverside Community Hospital Hospital, Riverside, CA, CCN 050022

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Darin Rentz DO PC

  • Anesthesiology Physician
  • Redlands, CA
  • NPI 1689321747

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Palm Springs Anesthesia Services, PC

  • Anesthesiology Physician
  • San Bernardino, CA
  • NPI 1083928501
  Medicare reassignment Care Compare group NPD

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

• Dignity Health

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  Care Compare affiliation
• Riverside Healthcare System, L.P.

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1114971660
  Care Compare affiliation

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1124733555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 QUEENSBERRY ST APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044836",
            "telephone_number": "909-269-1947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "MATTHEW",
        "credential": "SRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-19",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002412",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MA",
            "license": "RN2351699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnae Lynn Perryman
• Denise Renee Persichino, DO
• Lena Inger Persson, PT
• Prinka Perswani, MD
• Nelly M Pete
• Jessica Alicia Petersen
• Holley Ann Peterson-Funn
• Jacquelyn Peterson, PSY.D.
• Ly Ngoc Petrie, D.D.S.
• Amanda Petros, SLP

• Certified Registered Nurse Anesthetist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.