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

Matthew Petersen, PA

Individual provider Surgical Physician Assistant · NPI 1053764639

Matthew Petersen, PA is a Physician Assistant in Houston, Texas. Qualified in 2016, 10 years ago. Practices with Ortholonestar PLLC, a 415-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
10
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

10425 Huffmeister Rd Ste 320
Houston, TX 77065-3429
Phone: (281) 955-2650
Fax: (281) 955-5875
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 22485 Tomball Pkwy Ste 2100, Houston, TX 77070-1560 — (281) 955-2650

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1053764639
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 19, 2016
Last updated in NPPESApril 28, 2022
Certification dateApril 28, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Ortholonestar Pllc — 415 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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