Individual provider Active NPI

Matthew James Wasco, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Ypsilanti, MI
National Provider Identifier
1063635274
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301083495 Issued in MI
Practice address
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3161
Fax
(734) 712-2244
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 4301083495 MI
Student in an Organized Health Care Education/Training Program 390200000X 4301083495 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301083495 MI Primary

Addresses

Primary practice location

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Mailing address

PO Box 446
Ann Arbor, MI 48106-0446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081021000804 MI Practitioner - Pathology 1254499213 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Massachusetts Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301083495MIMDBlood Banking & Transfusion Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation CurrentSince May 30, 2013 Accepting new patients
St Mary Mercy Hospital Crna Current Accepting new patients
Chelsea Community Hospital Current Accepting new patients
Chelsea Community Hospital CurrentSince Jul 15, 2011 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
St Mary Mercy Hospital Current Accepting new patients
St Mary Mercy Hospital Professional Current Accepting new patients
Iha Health Service Corporation CurrentSince May 30, 2013 Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Apr 21, 2012 Accepting new patients
Michigan Multispecialty Physicians, P.C. Blood Banking & Transfusion Medicine Past Accepting new patients

Locations

16507 Southfield Rd
Allen Park, MI 48101
Phone (313) 389-0648

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

400 W Russell St
Saline, MI 48176
Phone (734) 429-1500

5333 McAuley Dr
Rm 3001
Ypsilanti, MI 48197
Phone (734) 712-4120

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5301 McAuley Dr
#69504
Ypsilanti, MI 48197
Phone (734) 712-2419

Organizations & group practices 10

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1063635274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481060446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3161",
            "fax_number": "734-712-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASCO",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MI",
            "license": "4301083495",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301083495",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301083495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.