DR. MATTHEW PETERSEN DO
NPI 1396206397
Internal Medicine - Cardiovascular Disease in San Luis Obispo, CA

Q: What is Matthew Petersen's NPI number?

The NPI number for Matthew Petersen is 1396206397. It was assigned to this individual provider in the NPPES registry on March 31, 2019.

Q: What is Matthew Petersen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Petersen was last updated on August 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 31, 2019PECOS Enrolled

1941 JOHNSON AVE STE 101, SAN LUIS OBISPO, CA 93401(805) 782-8844(805) 549-6985 Get Directions Write a Review

NPPES record last updated: August 28, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 28, 2026, Jul 14, 2026, May 18, 2026 and 1 more (4 updates tracked since 2022).

On this page

About Dr. Matthew Petersen Do NPPES

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

DR. MATTHEW PETERSEN DO (NPI 1396206397) is an individual cardiovascular disease provider in San Luis Obispo, California, licensed in California (20A24105) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1396206397

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameDR. MATTHEW PETERSENCredential: DO

Location Address1941 JOHNSON AVE STE 101San Luis Obispo, CA 93401-4154

Mailing Address1941 Johnson Ave Ste 101San Luis Obispo, CA 93401-4154 · (805) 872-8844

Phone(805) 782-8844

Fax(805) 549-6985

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 31, 2019

Last NPPES UpdateAugust 28, 20264 updates tracked since enumeration

NPPES CertifiedAugust 28, 2026

✔ NPI 1396206397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in CA · 20A24105

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1941 JOHNSON AVE STE 101, San Luis Obispo, CA 93401

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11941 Johnson Ave Ste 102San Luis Obispo, CA 93401-4174 · Phone (805) 782-8844 · Fax (805) 549-6986

Location 2295 Posada Ln Ste ATempleton, CA 93465-4055 · Phone (805) 782-8844 · Fax (805) 549-6987

Location 3850 Fair Oaks Ave Ste 100Arroyo Grande, CA 93420-3929 · Phone (805) 782-8844 · Fax (805) 549-6988

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Matthew Petersen Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3375875842

PECOS Enrollment IDI20260817002170

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.

Medicare Billing Reassignment

Medicare enrollment records show Matthew Petersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pacific Central Coast Health Centers

Same address

Community Health

1941 JOHNSON AVE STE 101
San Luis Obispo, CA 93401

Reassigned Medicare billing, California enrollment
263 clinicians in this Medicare group

NPI 1467299388 (805) 782-8844

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93401 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

$135.73 typical visit price

range $59.84 – $178.89

Typical copayment $33.93 (range $14.96 – $44.72)

Most-billed visit code 99204

Established Patient

$74.24 typical visit price

range $19.70 – $146.55

Typical copayment $18.56 (range $4.92 – $36.63)

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 16

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

KELLAN KALBAUGH PA-C

Physician Assistant (Medical)