Individual provider Active NPI

Matthew Myers Peters, CNP

  • Family Nurse Practitioner
  • T Or C, NM
National Provider Identifier
1386976397
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61497 Issued in NM
Practice address
800 E 9TH Ave
T Or C, NM 87901-1954
Phone
(575) 894-3221
Fax
(575) 894-4999
NPI assigned
Feb 2, 2010
Last updated
May 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN1025634 DC
Family Nurse Practitioner 363LF0000X 61497 NM Primary
Primary Care Nurse Practitioner 363LP2300X 0024147900 VA

Addresses

Primary practice location

800 E 9TH Ave
T Or C, NM 87901-1954

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (540) 222-0869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20220922000440 NM Practitioner - Nurse Practitioner 9638349046 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ess Hospitalist LLCGroup PAC ID 6103085295, 19 clinicians
Emergency Staffing Solutions IncGroup PAC ID 9830001650, 57 clinicians
Sierra Vista HospitalGroup PAC ID 0143122416, 64 clinicians

Practice addresses (Care Compare)

1313 E 32ND St
Silver City, NM 88061-7251
Phone (575) 538-4000

800 E 9TH Ave
T Or C, NM 87901-1954

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1025634DCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Jun 13, 2022 Accepting new patients
Emergency Staffing Solutions Inc CurrentSince Mar 23, 2024 Accepting new patients
Presbyterian Medical Services CurrentSince Jun 13, 2022 Accepting new patients
Las Cruces HB Medical Services LLC CurrentSince Dec 1, 2024 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Apr 13, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Apr 13, 2023 Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Sierra Vista Hospital CurrentSince May 8, 2024 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Ess Hospitalist LLC CurrentSince Dec 17, 2023 Accepting new patients
Sierra Vista Hospital Past Accepting new patients

Locations

1850 E Historic Highway 66
Gallup, NM 87301
Phone (505) 722-9334

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 726-6875

2811 N Main St
Las Cruces, NM 88001
Phone (575) 526-0080

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

1313 E 32nd St
Silver City, NM 88061
Phone (505) 537-4953

800 E 9th Ave
Truth Or Consequences, NM 87901
Phone (505) 743-1270

Organizations & group practices 12

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

Hospital & facility affiliations 3

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": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1386976397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875042267",
            "telephone_number": "540-222-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 9TH AVE",
            "city": "T OR C",
            "state": "NM",
            "postal_code": "879011954",
            "telephone_number": "575-894-3221",
            "fax_number": "575-894-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MATTHEW",
        "middle_name": "MYERS",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DC",
            "license": "RN1025634",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "61497",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024147900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in T Or C, NM

Sources for this page

Verify at the official NPI Registry.