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

Mateo F Nicholson, DO

Individual provider Internal Medicine Physician · NPI 1659833366

Mateo F Nicholson, DO is a Physical Medicine and Rehabilitation in Fort Wayne, Indiana. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2019, 7 years ago. Practices with Parkview Health System Inc, a 1,336-clinician group and accepts Medicare assignment. Licensed in Illinois, Indiana, Minnesota and Wisconsin.

Years since qualifying
7
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
IL, IN, MN, WI
In the registry since
2019
Specialties on file
5
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

2231 Carew St
Fort Wayne, IN 46805-4713
Phone: (260) 425-6780
Fax: (260) 373-9225
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 02007853A (IN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 125074919 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 33866 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 75957-21 (WI)

Record details

NPI number1659833366
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 2, 2019
Last updated in NPPESOctober 2, 2024
Certification dateOctober 2, 2024
Mailing address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2019 (7 years in practice)
Group practice Parkview Health System Inc — 1336 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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