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

Matthew D Peterson, PA-C

Individual provider Physician Assistant · NPI 1750803474

Matthew D Peterson, PA-C is a Physician Assistant in Kenosha, Wisconsin. Qualified in 2017, 9 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

10400 75th St
Kenosha, WI 53142-7884
Phone: (262) 948-5600
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 9555 76th St, Pleasant Prairie, WI 53158-1984 — (414) 290-6720

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4071-23 (WI)

Record details

NPI number1750803474
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 14, 2017
Last updated in NPPESNovember 29, 2022
Certification dateNovember 29, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Kenosha