NPIMap

Individual provider Active NPI

Matthew J Anderson, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1114171733
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4337 Issued in AZ
Practice address
124 W Thomas Rd Ste 103
Phoenix, AZ 85013-4415
Phone
(602) 406-4325
Fax
(602) 406-4377
NPI assigned
Nov 10, 2008
Last updated
May 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4337 AZ Primary
Surgical Physician Assistant 363AS0400X 4337 AZ

Addresses

Primary practice location

124 W Thomas Rd Ste 103
Phoenix, AZ 85013-4415

Mailing address

124 W Thomas Rd Ste 103
Phoenix, AZ 85013-4415
Phone (406) 602-4325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223001922 AZ Practitioner - Physician Assistant 0244391050 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
NM Pacs 2 LLCGroup PAC ID 3375892060, 108 clinicians
Arizona Post-Acute Medical Services 1 PCGroup PAC ID 4688951239, 18 clinicians
CS Pacs 3 West LLCGroup PAC ID 8921546797, 12 clinicians

Practice addresses (Care Compare)

255 W Brown Rd
Mesa, AZ 85201-3404
Phone (480) 833-3988

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3000

5755 E Main St
Mesa, AZ 85205-8814
Phone (480) 214-2400

8825 S 7TH St
Phoenix, AZ 85042-7626
Phone (602) 243-6121

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Pathology Current Accepting new patients
Hospitalists of Arizona, LLC Past Accepting new patients

Locations

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1114171733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W THOMAS RD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134415",
            "telephone_number": "406-602-4325",
            "fax_number": "602-406-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W THOMAS RD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134415",
            "telephone_number": "602-406-4325",
            "fax_number": "602-406-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4337",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.