Individual provider Active NPI

Matthew Emerson Kaiser, PA-C

  • Medical Physician Assistant
  • Artesia, NM
National Provider Identifier
1053776708
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2018-0044 Issued in NM
Practice address
702 N 13TH St
Artesia, NM 88210
Phone
(575) 746-3119
Fax
(575) 748-8524
NPI assigned
Dec 23, 2015
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007593 MI
Medical Physician Assistant 363AM0700X PA2018-0044 NM Primary

Addresses

Primary practice location

702 N 13TH St
Artesia, NM 88210

Mailing address

702 N 13TH St
Artesia, NM 88210-1166
Phone (575) 746-3119

Other practice location 1

364 W Wright Ave
Shepherd, MI 48883-2502
Phone (989) 828-6691

Other identifiers 3

IdentifierTypeStateIssuer
5601007593OtherMIMI PA LICENSE PERMANENT ID
1130317OtherMINCCPA ID
PA2018-0044OtherNMNM PA LICENCING BOARD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkaiser@artesiageneral.com Direct
Direct Messaging Address mfp@artesiageneral.hin.us Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20180725001765 NM Practitioner - Physician Assistant 4284938614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Artesia General HospitalGroup PAC ID 9537070586, 44 clinicians

Practice addresses (Care Compare)

702 N 13TH St
Artesia, NM 88210-1166
Phone (575) 748-8000

712 N 13TH St
Artesia, NM 88210-1166
Phone (575) 748-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Feb 15, 2016 Accepting new patients
Mymichigan Medical Group CurrentSince Feb 15, 2016 Accepting new patients
Artesia General Hospital CurrentSince Jul 6, 2018 Accepting new patients
Artesia General Hospital Past Accepting new patients
Southwestern Regional Medical Center Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

5785 E Broadway Rd
Mt Pleasant, MI 48858
Phone (989) 773-9421

364 W Wright Ave
Shepherd, MI 48883
Phone (989) 828-6691

702 N 13th St
Artesia, NM 88210
Phone (505) 748-3333

Interoperability endpoints

  • Direct secure messaging: mfp@artesiageneral.hin.us

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1053776708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N 13TH ST",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101166",
            "telephone_number": "575-746-3119",
            "fax_number": "575-748-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N 13TH ST",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "88210",
            "telephone_number": "575-746-3119",
            "fax_number": "575-748-8524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "364 W Wright Ave",
            "address_purpose": "LOCATION",
            "city": "Shepherd",
            "state": "MI",
            "postal_code": "488832502",
            "country_code": "US",
            "telephone_number": "989-828-6691",
            "fax_number": "989-828-6835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAISER",
        "first_name": "MATTHEW",
        "middle_name": "EMERSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-23",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007593",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2018-0044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI PA LICENSE PERMANENT ID",
            "identifier": "5601007593",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA ID",
            "identifier": "1130317",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM PA LICENCING BOARD",
            "identifier": "PA2018-0044",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkaiser@artesiageneral.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "702 N 13th St",
            "city": "Artesia",
            "state": "NM",
            "country_code": "US",
            "postal_code": "882101166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfp@artesiageneral.hin.us",
            "affiliation": "N",
            "endpointDescription": "EHR Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "702 N 13th St",
            "city": "Artesia",
            "state": "NM",
            "country_code": "US",
            "postal_code": "88210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Artesia, NM

Sources for this page

Verify at the official NPI Registry.