DR. JONATHAN MATTHEW PETTEGREW (D.O.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1053552745
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,024 ORTHOPEDIC SURGERY in CA
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Provider Addresses for DR. JONATHAN MATTHEW PETTEGREW (D.O.)
609, East Orangeburg Avenue, Modesto, Stanislaus County, California, 95350, United States
SUITE 201
MODESTO, CA 953505512
Phone: (209) 572-3224
Fax: (209) 572-4528
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $2,657.
Total Amount is formed as General ($2,657) + Research ($0) + Ownership ($0) = $2,657.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: Arthrex, Inc. ($2,449).
Total Amount
$2,657
General + Research + Ownership
Payments
23
Total payment records
General Amount
$2,657
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Arthrex, Inc. | $2,449 |
| Cornerstone Medical Associates, Inc. | $208 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-07-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140702002173 | I | Orthopedic Surgery | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 244 | 37 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 55 | 37 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 53 | 36 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 26 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 24 | 22 | $0 |
Insurance plans in this area (ZIP 95350)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery, Hand Surgery | CA | |
| Occupational Therapist In Private Practice | CA | |
| Orthopedic Surgery | WA | |
| Occupational Therapist In Private Practice | NV | |
| Orthopedic Surgery | CA | |
| P O D I A T R Y | CA | |
| Orthopedic Surgery | CA | |
| - | CA | |
| Physical Therapist In Private Practice | CA |
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