Matthew L Petersen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TEP5663 Issued in NE

Practice address

4600 Valley Road
Suite 200
Lincoln, NE 68510-4844

Phone

(402) 483-4571

Fax

(402) 483-5079

NPI assigned

Jul 6, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Family Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beatrice Community Hospital and Health Center IncGroup PAC ID 1951208222, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beatrice Community Hospital & Health Center, Inc Hospital, Beatrice, NE, CCN 281364

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/06e9d567-9657-447f-97fb-d967654387e7/

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.

• Beatrice Community Hospital & Health Center Inc

  • Emergency Medicine Physician
  • Beatrice, NE
  • NPI 1922111855
  Medicare reassignment Care Compare group NPD
• Saunders Medical Center

  • Rural Health Clinic/Center
  • Wahoo, NE
  • NPI 1467442244
  Medicare reassignment NPD
• Saunders Medical Center

  • Critical Access Hospital
  • Wahoo, NE
  • NPI 1831188705
  Medicare reassignment NPD
• Beatrice Community Hospital & Health Center Inc

  • Critical Access Hospital
  • Beatrice, NE
  • NPI 1184642894
  Medicare reassignment
• Saunders Medical Center

  • Skilled Nursing Facility
  • Wahoo, NE
  • NPI 1013364678
  NPD

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

• Beatrice Community Hospital & Health Center Inc

  • Critical Access Hospital
  • Beatrice, NE
  • NPI 1184642894
  Care Compare affiliation

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558569038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 VALLEY ROAD",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104844",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 VALLEY ROAD",
            "address_2": "SUITE 200",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104844",
            "telephone_number": "402-483-4571",
            "fax_number": "402-483-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP5663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47055301100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Petersen, MA
• Jacob F Petersen
• Jennifer Suzanne Petersen, RN, IBCLC
• Lindsey Petersen
• Malinda Lee Petersen
• Megan Petersen, PHARMD
• Michelle A Petersen, PA-C
• Michelle B Petersen, M.D.
• Paul F Petersen, MD
• Sharee Petersen

• Family Medicine Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.