Individual provider Active NPI

Matthew Sanders

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1063051001
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4437 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 545-8090
Fax
(901) 545-6809
NPI assigned
Dec 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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 4437 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

1640 W Division St Apt 1405
Chicago, IL 60622-3942
Phone (412) 216-7572

Other practice location 1

1640 W Division St Apt 1405
Chicago, IL 60622-3942
Phone (412) 216-7572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210308001270 TN Practitioner - Physician Assistant 8527474089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

6215 Humphreys Blvd
Suite 201
Memphis, TN 38120-2382
Phone (901) 866-8085

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

877 Jefferson Ave
Memphis, TN 38103-2897

Hospital & facility affiliations

  • Regional One Health Hospital, Memphis, TN, CCN 440152

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4437TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Physician Assistant CurrentSince Mar 17, 2021 Accepting new patients

Locations

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

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 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": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1063051001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 W DIVISION ST APT 1405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223942",
            "telephone_number": "412-216-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-8090",
            "fax_number": "901-545-6809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1640 W Division St Apt 1405",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606223942",
            "country_code": "US",
            "telephone_number": "412-216-7572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-21",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.