DR. MATTHEW SHANE PETERSON M.D
NPI 1255319828
Obstetrics & Gynecology in Kennesaw, GA

Active since January 04, 2006PECOS EnrolledAccepts Medicare Assignment
750 TOWNPARK LN NW, KENNESAW, GA 30144(404) 365-0966 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Matthew Shane Peterson M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTHEW SHANE PETERSON M.D (NPI 1255319828) is an individual obstetrics & gynecology provider in Kennesaw, Georgia, licensed in Georgia (85640) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1997).

NPPES Registry Identity

NPI1255319828
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. MATTHEW SHANE PETERSONCredential: M.D
Location Address750 TOWNPARK LN NWKennesaw, GA 30144-5579
Mailing Address750 Townpark Ln NwKennesaw, GA 30144-5579 · (404) 365-0966
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1997
Enumeration DateJanuary 4, 2006
Last NPPES UpdateJanuary 22, 2025
NPPES CertifiedDecember 23, 2024
NPI 1255319828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses Licensed in GA · 85640 Licensed in NC · 200200772
Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

750 TOWNPARK LN NW, Kennesaw, GA 30144

Other Identifiers 1

Medicaid89132R9NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Matthew Shane Peterson M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971565763
PECOS Enrollment IDI20200723003754
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinical Medical Laboratory
750 TOWNPARK LN NW
KENNESAW, GA 30144
Pediatrics
750 TOWNPARK LN NW
KENNESAW, GA 30144
Pharmacist
750 TOWNPARK LN NW
KENNESAW, GA 30144
Family Medicine
750 TOWNPARK LN NW
KENNESAW, GA 30144
Pharmacist (Pain Management)
750 TOWNPARK LN NW
KENNESAW, GA 30144
Family Medicine
750 TOWNPARK LN NW, KAISER PERMANENTE TOWNPARK MEDICAL CENTER
KENNESAW, GA 30144
Physician Assistant
750 TOWNPARK LN NW, KAISER PERMANENTE TOWNPARK COMPREHENSIVE MEDICAL CENTER
KENNESAW, GA 30144
Physician Assistant
750 TOWNPARK LN NW, KAISER PERMANENTE TOWN PARK COMPREHENSIVE MEDICAL CENTE
KENNESAW, GA 30144

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Peterson's NPI number?

The NPI number for Matthew Peterson is 1255319828. It was assigned to this individual provider in the NPPES registry on January 4, 2006.

Where is Matthew Peterson located?

Matthew Peterson practices at 750 Townpark Ln NW, Kennesaw, GA 30144. The listed phone number is (404) 365-0966.

What is Matthew Peterson's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Matthew Peterson enrolled in Medicare?

Yes. Matthew Peterson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Matthew Peterson was last updated on January 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.