Individual provider Active NPI

Matthew Joseph Homishak, CRNA

  • Certified Registered Nurse Anesthetist
  • Newark, DE
National Provider Identifier
1003565078
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
L6-0A10940 Issued in DE
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-9800
Phone
(302) 733-1000
NPI assigned
Mar 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN719847 PA
Certified Registered Nurse Anesthetist 367500000X RN719847 PA
Certified Registered Nurse Anesthetist 367500000X L6-0A10940 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-9800

Mailing address

110 Clover Dr
Hockessin, DE 19707-1321
Phone (484) 894-6429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220915001335 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062897812 Reassigns benefits to 1 organization
I20231120002738 DE Practitioner - Certified Registered Nurse Anesthetist (Crna) 2062897812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services PA 201 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1000

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN719847PAMDRegistered Nurse
L6-0A10940DEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jun 20, 2022 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jun 20, 2022 Accepting new patients
Anesthesia Services PA CurrentSince Oct 30, 2023 Accepting new patients

Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

2600 Glasgow Ave
Ste 226
Newark, DE 19702
Phone (302) 836-3539

100 N Academy Ave
Danville, PA 17822

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1003565078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CLOVER DR",
            "city": "HOCKESSIN",
            "state": "DE",
            "postal_code": "197071321",
            "telephone_number": "484-894-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197189800",
            "telephone_number": "302-733-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMISHAK",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN719847",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN719847",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DE",
            "license": "L6-0A10940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.