Individual provider Active NPI

Matthew A Stetter, DO

  • Family Medicine Physician
  • Morton, IL
National Provider Identifier
1205935848
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036100882 Issued in IL
Practice address
621 W Jackson St
Morton, IL 61550
Phone
(309) 263-4343
Fax
(309) 263-1363
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036100882 IL Primary

Addresses

Primary practice location

621 W Jackson St
Morton, IL 61550

Mailing address

1120 E War Memorial
Peoria Heights, IL 61616
Phone (309) 685-0100

Other identifiers 1

IdentifierTypeStateIssuer
L82755OtherILPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322001056 IL Practitioner - Family Practice 2567418601 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343

201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627

205 N Cummings LN
Suite B
Washington, IL 61571-2181
Phone (309) 691-6610

209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185

3591 Griffin Ave
Pekin, IL 61554-6258
Phone (309) 353-6301

5401 N Knoxville Ave
Peoria, IL 61614-5021

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions33
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036100882ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Feb 6, 2004 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

815 Main St
Ste A1
Peoria, IL 61602

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: mstetterdo388560@carlehiedirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205935848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E WAR MEMORIAL",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "61616",
            "telephone_number": "309-685-0100",
            "fax_number": "309-685-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W JACKSON ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "61550",
            "telephone_number": "309-263-4343",
            "fax_number": "309-263-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETTER",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036100882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "L82755",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.