Individual provider Active NPI

Matthew James Cunningham, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1104295278
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1141 Moosic St
Scranton, PA 18505-2105
Phone
(570) 800-5926
Fax
(570) 955-5556
NPI assigned
Sep 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 Primary

Addresses

Primary practice location

1141 Moosic St
Scranton, PA 18505-2105

Mailing address

1141 Moosic St
Scranton, PA 18505-2105
Phone (570) 800-5926

Other practice location 1

677 Kidder St Ste D
Wilkes Barre Township, PA 18702-6914
Phone (570) 825-2046

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
I20240729000884 PA Practitioner - Physician Assistant 0446532253 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jun 6, 2024 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jun 6, 2024 Accepting new patients
Parkview Orthopaedic Group S C Past Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

677 Kidder St
Ste D
Wilkes Barre Township, PA 18702
Phone (570) 825-2046

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1104295278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-800-5926",
            "fax_number": "570-955-5556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Kidder St Ste D",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre Township",
            "state": "PA",
            "postal_code": "187026914",
            "country_code": "US",
            "telephone_number": "570-825-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-18",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.