NPIMap

Individual provider Active NPI

Matthew L. Nettleton, MD

  • Internal Medicine Physician
  • Blairsville, PA
National Provider Identifier
1114983616
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD422459 Issued in PA
Practice address
25 Colony Boulevard
Suite 102
Blairsville, PA 15717-7971
Phone
(724) 459-9111
Fax
(724) 459-7856
NPI assigned
Apr 24, 2006
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD422459 PA Primary

Addresses

Primary practice location

25 Colony Boulevard
Suite 102
Blairsville, PA 15717-7971

Mailing address

25 Colony Boulevard
Suite 102
Blairsville, PA 15717-7971
Phone (724) 459-9111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.nettleton@irmc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20031111000814 PA Practitioner - Internal Medicine 3779496096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Klain, Heasley, Nettleton MD, PCGroup PAC ID 1658283718, 5 clinicians

Practice addresses (Care Compare)

1265 Wayne Ave
Suite 102
Indiana, PA 15701-3578
Phone (724) 349-4411

280 Indian Springs Rd
Suite 131
Indiana, PA 15701-3676
Phone (724) 463-9300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD422459PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JK Marketing, LLC CurrentSince May 1, 2021 Accepting new patients
JK Marketing, LLC CurrentSince May 1, 2021 Accepting new patients
Klain, Heasley, Nettleton MD PC Internal Medicine CurrentSince Sep 1, 2003 Accepting new patients
Indiana Skilled Nursing Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Your Compounding Pharmacy, LLC Past Accepting new patients
County of Indiana Past Accepting new patients

Locations

155 E Market St
Blairsville, PA 15717
Phone (724) 459-6610

25 Colony Blvd
Ste 102
Blairsville, PA 15717
Phone (724) 459-9111

1265 Wayne Ave
Ste 102
Indiana, PA 15701
Phone (724) 349-4411

280 Indian Springs Rd
Indiana, PA 15701
Phone (724) 463-9300

280 Indian Springs Rd
Ste 125
Indiana, PA 15701
Phone (724) 463-9300

280 Indian Springs Rd
Ste 131
Indiana, PA 15701
Phone (724) 463-9300

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

Organizations & group practices 7

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1114983616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COLONY BOULEVARD",
            "address_2": "SUITE 102",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157177971",
            "telephone_number": "724-459-9111",
            "fax_number": "724-459-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COLONY BOULEVARD",
            "address_2": "SUITE 102",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157177971",
            "telephone_number": "724-459-9111",
            "fax_number": "724-459-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "MATTHEW",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-24",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD422459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.nettleton@irmc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Millennium Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct messaging",
            "address_1": "25 Colony Boulevard",
            "address_2": "Suite 102",
            "city": "Blairsville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "157177971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blairsville, PA

Sources for this page

Verify at the official NPI Registry.