Individual provider Active NPI

Matthew Peters, M.D.

  • Family Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1912439506
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD187759 Issued in OR
Practice address
2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1130
Phone
(541) 274-8400
Fax
(541) 274-8405
NPI assigned
Apr 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD187759 OR Primary

Addresses

Primary practice location

2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1130

Mailing address

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 882-6311

Other practice location 1

2865 Daggett Ave
Klamath Falls, OR 97601-1106
Phone (541) 274-6110

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200930003587 OR Practitioner - Family Practice 1052684990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2821 Daggett Ave
Suite 200
Klamath Falls, OR 97601-1130
Phone (541) 274-8400

Hospital & facility affiliations

  • Klamath Hospice, Inc. Hospice, Klamath Falls, OR, CCN 381533
  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Lakes Medical Center Inc CurrentSince Oct 26, 2020 Accepting new patients
Sky Lakes Medical Center Inc CurrentSince Oct 26, 2020 Accepting new patients
Sky Lakes Medical Center Inc Past Accepting new patients

Locations

2865 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 833-6221

2801 Daggett Ave
Klamath Falls, OR 97601
Phone (541) 274-4510

2821 Daggett Ave
Ste 200
Klamath Falls, OR 97601
Phone (541) 274-8400

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1912439506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 DAGGETT AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011106",
            "telephone_number": "541-882-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 DAGGETT AVE STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011130",
            "telephone_number": "541-274-8400",
            "fax_number": "541-274-8405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2865 Daggett Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976011106",
            "country_code": "US",
            "telephone_number": "541-274-6110",
            "fax_number": "541-274-6106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-01",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD187759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.