Individual provider Active NPI

Matthew R Wilber, DPM

  • Primary Podiatric Medicine Podiatrist
  • Bettendorf, IA
National Provider Identifier
1114904257
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
639 Issued in IA
Practice address
2332 Cumberland Square Dr
Bettendorf, IA 52722-3219
Phone
(563) 391-2889
Fax
(563) 391-2988
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 639 IA Primary

Addresses

Primary practice location

2332 Cumberland Square Dr
Bettendorf, IA 52722-3219

Mailing address

2332 Cumberland Square Dr
Bettendorf, IA 52722-3219
Phone (563) 391-2889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080612000278 IL Practitioner - Podiatry 4880584598 Reassigns benefits to 3 organizations
I20131108000729 IA Practitioner - Podiatry 4880584598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quad Cities Foot and Ankle Associates PCGroup PAC ID 7618102831, 4 clinicians

Practice addresses (Care Compare)

2332 Cumberland Square Dr
Bettendorf, IA 52722-3219
Phone (563) 391-2889

2570 24TH St
Suite 122
Rock Island, IL 61201-5394
Phone (563) 391-2889

Hospital & facility affiliations

  • Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275

Merit-based Incentive Payment System (MIPS)

Final score
79.98 of 100Reported as individual
Quality
63.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1279
Removal or shaving of skin growth390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
639IAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Center Current Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Genesis Health System CurrentSince Mar 10, 2020 Accepting new patients
Trinity Medical Center CurrentSince Jul 15, 2015 Accepting new patients
Quad Cities Foot & Ankle Associates PC Primary Podiatric Medicine CurrentSince Sep 1, 2013 Accepting new patients
Orthopaedic Specialists PC Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 110
Bettendorf, IA 52722
Phone (563) 340-3095

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

2332 Cumberland Square Dr
Bettendorf, IA 52722
Phone (563) 391-2889

3385 Dexter Ct
Ste 300
Davenport, IA 52807
Phone (563) 344-9292

3940 Marquette St
Davenport, IA 52806
Phone (563) 386-3111

1901 7th St
Moline, IL 61265
Phone (309) 764-6006

600 Valley View Dr
Moline, IL 61265
Phone (309) 757-7196

500 John Deere Rd
Moline, IL 61265
Phone (309) 779-2840

600 Valley View Dr
Lowr L
Moline, IL 61265
Phone (563) 344-9292

2570 24th St
Ste 122
Rock Island, IL 61201
Phone (309) 779-3868

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11329/brand/1/csg/1/fhir/r4
  • Direct secure messaging: matthew.wilber.1@11329.direct.athenahealth.com
  • Direct secure messaging: mwilber92564@direct.unitypoint.org

Organizations & group practices 6

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 3

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1114904257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223219",
            "telephone_number": "563-391-2889",
            "fax_number": "563-391-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223219",
            "telephone_number": "563-391-2889",
            "fax_number": "563-391-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBER",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IA",
            "license": "639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

Verify at the official NPI Registry.