DR. MATTHEW R PEVERILL (PHD) – Clinical Psychologist, NPI 1114749249

DR. MATTHEW R PEVERILL (PHD) is a healthcare provider. based in Madison, Wisconsin. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 5251-57 (WI). The NPI Number for DR. MATTHEW R PEVERILL (PHD) is 1114749249

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. MATTHEW R PEVERILL (PHD)
NPI
1114749249
Phone
(857) 277-9083
Address
4314 CRITCHELL TER
Enumeration Date
29 October 2024
Last Update Date
29 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6082769191
Graduation Year
2021 (5 years ago)
PAC ID
9133654890
Group Practice PAC ID
1850285826
Professional Enrollment ID
I20241119001522
Address ID
WI537112476MA700XXDRXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:1State licenses:1Digital endpointsOther names

667 CLINICAL PSYCHOLOGIST in WI

Provider Addresses for DR. MATTHEW R PEVERILL (PHD)

  • 4314 CRITCHELL TER

    MADISON, WI 537111535

    Phone: (857) 277-9083

    Type: Mailing

  • 700 RAY O VAC DR STE 220

    MADISON, WI 537112476

    Phone: (608) 276-9191

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-11-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241119001522IClinical PsychologistWITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53711)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850285826View full group profile
NameSpecialtyState
Marriage And Family TherapistWI
-WI
Mental Health CounselorWI
Mental Health CounselorWI
P S Y C H I A T R YWI
Clinical Social WorkerWI
-WI
-WI
-WI
-WI

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MATTHEW R PEVERILL (PHD)?
DR. MATTHEW R PEVERILL (PHD) — NPI 1114749249 — is the standard way to identify this listing.
Is DR. MATTHEW R PEVERILL (PHD) listed as active for patients and plans?
The listing shows DR. MATTHEW R PEVERILL (PHD) as active in the NPI system.
What is DR. MATTHEW R PEVERILL (PHD) best known for clinically?
Directory data describes DR. MATTHEW R PEVERILL (PHD) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MATTHEW R PEVERILL (PHD)?
DR. MATTHEW R PEVERILL (PHD)'s geographic hint is Madison, Wisconsin in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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