Matthew Roland Nothern, NP PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

A16544 Issued in CA

Practice address

3200 Long Beach Boulevard
Long Bech, CA 90806-5062

Phone

(562) 981-6865

Fax

(562) 595-6471

NPI assigned

Oct 12, 2006

Last updated

Aug 31, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

University of California, Davis School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oc Urgentcare Medical Group IncorporatedGroup PAC ID 3375672835, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADEBBD

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.

• Oc Urgentcare Medical Group Incorporated

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1083940597
  Medicare reassignment Care Compare group
• Oc Urgentcare Medical Group Incorporated

  dba Oc Urgent Care Anaheim 2

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1124692314
  NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Colton, CA
  • NPI 1306899166
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1124117700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E HILL STREET",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907553682",
            "telephone_number": "562-424-6200",
            "fax_number": "562-427-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 LONG BEACH BOULEVARD",
            "city": "LONG BECH",
            "state": "CA",
            "postal_code": "908065062",
            "telephone_number": "562-981-6865",
            "fax_number": "562-595-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTHERN",
        "first_name": "MATTHEW",
        "middle_name": "ROLAND",
        "credential": "NP PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "A16544",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13855",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.