Individual provider Active NPI

Matthew Cade Bross, PA-C

  • Physician Assistant
  • Bethany, OK
National Provider Identifier
1003582842
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4979 Issued in OK
Practice address
6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone
(405) 789-6711
Fax
(405) 349-5145
NPI assigned
Aug 20, 2021
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4979 OK Primary

Addresses

Primary practice location

6800 NW 39TH Expy
Bethany, OK 73008-2513

Mailing address

6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone (405) 789-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4979OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Center Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1003582842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082513",
            "telephone_number": "405-789-6711",
            "fax_number": "405-349-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 NW 39TH EXPY",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730082513",
            "telephone_number": "405-789-6711",
            "fax_number": "405-349-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSS",
        "first_name": "MATTHEW",
        "middle_name": "CADE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-20",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethany, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.