Matthew Petersen, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

20A24105 Issued in CA

Practice address

1941 Johnson Ave Ste 101
San Luis Obispo, CA 93401-4154

Phone

(805) 782-8844

Fax

(805) 549-6985

NPI assigned

Mar 31, 2019

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: mpetersen343882@direct.shands.ufl.edu

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1396206397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014154",
            "telephone_number": "805-872-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 JOHNSON AVE STE 101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014154",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Posada Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934654055",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1941 Johnson Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934014174",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 Fair Oaks Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arroyo Grande",
            "state": "CA",
            "postal_code": "934203929",
            "country_code": "US",
            "telephone_number": "805-782-8844",
            "fax_number": "805-549-6988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "20A24105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C Jill Pesavento, MFT
• Peter C. Nelson DDS, Inc.
• Joshua Michael Peters, LMFT
• Sarah J Peters
• Austin Petersen
• Lewis Dale Peterson
• Lisa Marie Peterson
• Mishelle Petit
• James Petrik, D.D.S.
• Pharmarx Pharmaceutical Inc

• Cardiovascular Disease Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.