Individual provider Active NPI

Matthew Thomas Lavelle, CRNP

  • Gerontology Clinical Nurse Specialist
  • Pittsburgh, PA
National Provider Identifier
1043678436
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
SPO15635 Issued in PA
Practice address
4815 Liberty Ave Ste GR10
Pittsburgh, PA 15224-2156
Phone
(412) 235-5874
Fax
(412) 235-5877
NPI assigned
Feb 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SPO15635 PA
Adult Health Clinical Nurse Specialist 364SA2200X SPO15635 PA
Gerontology Clinical Nurse Specialist 364SG0600X SPO15635 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste GR10
Pittsburgh, PA 15224-2156

Mailing address

4815 Liberty Ave Ste GR10
Pittsburgh, PA 15224-2156
Phone (412) 235-5874

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlavelle61310@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160308000102 PA Practitioner - Nurse Practitioner 4486950144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

320 E N Ave
Pittsburgh, PA 15212-4756

62 Greenbriar Dr
Suite 1
Leechburg, PA 15656-8209
Phone (724) 845-7765

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SPO15635PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC CurrentSince Apr 28, 2016 Accepting new patients
Allegheny Clinic Current Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Apr 28, 2016 Accepting new patients
Allegheny Clinic CurrentSince Jan 22, 2016 Accepting new patients
Allegheny Clinic CurrentSince Jan 22, 2016 Accepting new patients

Locations

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

4815 Liberty Ave
Ste GR10
Pittsburgh, PA 15224
Phone (412) 235-5858

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

4800 Friendship Ave
Pittsburgh, PA 15224
Phone (412) 359-3030

4727 Friendship Ave
Ste 200
Pittsburgh, PA 15224
Phone (412) 235-5810

Organizations & group practices 5

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 5

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": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1043678436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE GR10",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-235-5874",
            "fax_number": "412-235-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE GR10",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-235-5874",
            "fax_number": "412-235-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-01",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SPO15635",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "PA",
            "license": "SPO15635",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "PA",
            "license": "SPO15635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlavelle61310@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4727 Friendship Ave Ste 200",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152241778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.