Individual provider Active NPI

Carolyn M Matthews, PA-C

  • Medical Physician Assistant
  • Erie, PA
National Provider Identifier
1063883247
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA057899 Issued in PA
Practice address
2315 Myrtle St Ste L10
Erie, PA 16502-4611
Phone
(814) 454-2401
Fax
(814) 459-5992
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA057899 PA Primary

Addresses

Primary practice location

2315 Myrtle St Ste L10
Erie, PA 16502-4611

Mailing address

2315 Myrtle St Ste L10
Erie, PA 16502-4611
Phone (814) 452-2401

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmatthews217070@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
I20160104000974 PA Practitioner - Physician Assistant 1456653740 Reassigns benefits to 2 organizations

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
Orthopedic Associates of Meadville, P.C.Group PAC ID 0446151864, 17 clinicians

Practice addresses (Care Compare)

11277 Vernon PL
Suite 200
Meadville, PA 16335-3719
Phone (814) 724-1252

Hospital & facility affiliations

  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057899PAMDMedical Physician Assistant

Organizations & group practices 2

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": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1063883247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE L10",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024611",
            "telephone_number": "814-452-2401",
            "fax_number": "814-459-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRTLE ST STE L10",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165024611",
            "telephone_number": "814-454-2401",
            "fax_number": "814-459-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmatthews217070@direct.ahn.org",
            "affiliation": "N",
            "address_1": "2315 Myrtle St Ste L10",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165024611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.