Matthew J. Petersile, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

277195 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 334-3068

NPI assigned

Mar 22, 2016

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

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MA

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

Gastroenterology

Education

Boston University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Marlborough Hospital Hospital, Marlborough, MA, CCN 220049
• Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
• Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019
• Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetersile274064@umassmemorial.direct-ci.com
• FHIR API: https://7dd4c9b2-8c33-42e8-9be4-1fef2411298a.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  Medicare reassignment Care Compare group
• Digestive Health Specialists, P.C.

  • Gastroenterology Physician
  • Chelmsford, MA
  • NPI 1205895257
  Medicare reassignment NPD
• Medical Affiliates of Cape Cod, Inc.

  • Internal Medicine Physician
  • Hyannis, MA
  • NPI 1770534927
  Medicare reassignment NPD
• Medical Affiliates of Cape Cod, Inc.

  • Ambulatory Surgical Clinic/Center
  • Mashpee, MA
  • NPI 1306391206
  NPD

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

• Marlborough Hospital Corp

  • Registered Dietitian
  • Marlborough, MA
  • NPI 1104488170

  Hospital

  Care Compare affiliation Name & address match
• Cape Cod Hospital Inc

  • General Acute Care Hospital
  • Hyannis, MA
  • NPI 1114984671
  Care Compare affiliation
• Umass Memorial Health-Harrington Hospital Inc

  • General Acute Care Hospital
  • Southbridge, MA
  • NPI 1790780047
  Care Compare affiliation
• Umass Memorial Healthalliance Clinton Hospital Inc

  • General Acute Care Hospital
  • Leominster, MA
  • NPI 1013995133
  Care Compare affiliation
• Umass Memorial Healthalliance Clinton Hospital Inc

  • Psychiatric Hospital Unit
  • Clinton, MA
  • NPI 1285171934
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1639531544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521228",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016053094",
            "country_code": "US",
            "telephone_number": "508-334-8419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSILE",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2023-01-11",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "277195",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "277195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110116724A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpetersile274064@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• George B Peters III, M.D.
• Jazmine Peters
• Joshua Peters, MA
• Michael Joseph Peters Sr., CADC 1670AD
• Christine L Petersen, MD
• Ashley Elizabeth Peterson
• Beth Peterson, MS, RD, CSO, CNSC
• Carissa S Peterson, B.S.
• Christian Peterson
• Danna B. Peterson, MD

• Gastroenterology Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.