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

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1215046974

Matthew Pettengill, DPM is a Podiatry in Phoenix, Arizona. Qualified in 1997, 29 years ago. Practices with Dhhs Phs IHS Phoenix Area, a 24-clinician group and accepts Medicare assignment. Licensed in Maine and Pennsylvania.

Years since qualifying
29
Licensed in
ME, PA
In the registry since
2006
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

4212 N 16th St
Phoenix, AZ 85016-5319
Phone: (602) 263-1200
Fax: (602) 200-5383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence SC004785L (PA)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence POD1049 (ME)

Record details

NPI number1215046974
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedAugust 29, 2006
Last updated in NPPESJuly 29, 2011
Mailing addressPo Box 31001-0698, Pasadena, CA 91110-0698

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Dhhs Phs Ihs Phoenix Area — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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