Matthew Walter Maciejewski, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1378-25 Issued in WI

Practice address

303 Hake St
Fort Atkinson, WI 53538-1212

Phone

(920) 563-2136

NPI assigned

May 23, 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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Specialty

Podiatry

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1609568237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159",
            "telephone_number": "920-563-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HAKE ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381212",
            "telephone_number": "920-563-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIEJEWSKI",
        "first_name": "MATTHEW",
        "middle_name": "WALTER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1378-25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lys A Loney, RN
• David Luisier, D.D.S.
• Qingze LV, DMD
• Leah Clare Lyle, LMFT
• Elizabeth H Lynk, MD
• Jill Mallin, PHD, LP
• Matthew Mallin, LCSW
• Stephen Randall Marion, OD
• Betsy Martin Devine, PA C
• Emma Yvonne Martin, LPC-IT

• All providers in Fort Atkinson, WI
• Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.
• 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.