Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jonathan Matthew Pettegrew, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053552745

Dr. Jonathan Matthew Pettegrew, DO is an Orthopedic Surgery in Modesto, California. Qualified in 2008, 18 years ago. Practices with Stanislaus Orthopaedic and Sports Medicine Clinic, a 10-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2009
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

609 E Orangeburg Ave Ste 201
Modesto, CA 95350-5512
Phone: (209) 572-3224
Fax: (209) 572-4528
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 20A13395 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053552745
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 10, 2009
Last updated in NPPESJune 23, 2014
Mailing address609 E Orangeburg Ave, Suite 201, Modesto, CA 95350-5512

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Stanislaus Orthopaedic And Sports Medicine Clinic — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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