Michelle Anne Matyseck, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51876 Issued in CA

Practice address

8891 Central Ave
Montclair, CA 91763-1618

Phone

(909) 297-3361

NPI assigned

Aug 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Anne Dietz Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: michelle.matyseck.1@30646.direct.athenahealth.com

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.

• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178
  Medicare reassignment Care Compare group
• Zoomcare PC

  dba ZoomCare

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1093115941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15680 STANBROOK DR",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906385110",
            "telephone_number": "760-617-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8891 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631618",
            "telephone_number": "909-297-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYSECK",
        "first_name": "MICHELLE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DIETZ",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon Isabelle Martinez, PA
• Mary of Joy Hospice, Inc.
• Yahaira Mateo
• Alexis Elizabeth Matias
• Shalia Matthews
• Janie Mayer
• Alysha Mays
• Kristina Mays
• David McClellan
• Vonnetta McClendon

• Physician Assistant in Montclair, CA
• Providers in Montclair, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.