Matthew R Peterson, PA is a medicare enrolled "Physician Assistant" physician in Saint Louis, Missouri. He graduated from medical school in 2006 and has 18 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Vituity - Illinois Auc Llp and his current practice location is
10010 Kennerly Rd, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 525-1911.
Matthew R Peterson is licensed to practice in Illinois (license number 85-002763) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1285745711.
Physician's Profile
| Full Name | Matthew R Peterson |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 18 Years |
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| Location | 10010 Kennerly Rd, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Matthew R Peterson graduated from medical school in 2006
NPI Data:
- NPI Number: 1285745711
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 11/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 9830196070
- Enrollment ID: I20061031000276
Medical Identifiers
Medical identifiers for Matthew R Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1285745711 | NPI | - | NPPES |
| 1072542 | Other | | PHYSICIAN ASSISTANT CERTI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 085-002763 (Illinois) | Secondary |
| 363A00000X | Physician Assistant | 2008025807 (Missouri) | Secondary |
| 363A00000X | Physician Assistant | 85-002763 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Vituity - Illinois Auc Llp | 0547516932 | 28 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Matthew R Peterson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Matthew R Peterson, PA
102 Del Rio Ct,
Belleville, IL 62221-3181
Ph: (847) 691-3958 | Matthew R Peterson, PA
10010 Kennerly Rd,
Saint Louis, MO 63128-2106
Ph: (314) 525-1911 |
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