Matthew Preston Rainbolt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-05706 Issued in NC

Practice address

3619 Desert Rose LN
Lake Havasu City, AZ 86404-1748

Phone

(337) 349-6708

NPI assigned

Apr 12, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

98.67

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

85.01 of 100Reported as group

Quality

80.14

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.15 of 100Reported as group

Quality

81.36

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

86.02 of 100Reported as group

Quality

78.32

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mrainbolt764265@direct.novanthealth.org
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Ballantyne Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1164052726
  Medicare reassignment NPD (past)
• Stallings Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Matthews, NC
  • NPI 1235728031
  Medicare reassignment
• The Carolinas Emergency Group, PLLC

  • Emergency Medicine Physician
  • Dunn, NC
  • NPI 1477508836
  Medicare reassignment
• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment
• Western Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Albemarle, NC
  • NPI 1134391758
  Medicare reassignment

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1124414693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51131",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051131",
            "telephone_number": "337-349-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 DESERT ROSE LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864041748",
            "telephone_number": "337-349-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINBOLT",
        "first_name": "MATTHEW",
        "middle_name": "PRESTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-12",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6039",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrainbolt764265@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "3619 Desert Rose Ln",
            "city": "Lake Havasu City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864041748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brett Qualls, PT
• Edward J Quinn, MD
• Elaine Bontje Quinn, MA
• James Guzman Quintero, ASTR'S AOS
• Radiological Services of Northern Arizona, PC
• Raley'S Arizona LLC
• Raley'S Arizona LLC
• Megan Michelle Randall, FNP-BC
• Crystal Michelle Rapp, LMSW
• Maria Rawson, LAC

• Physician Assistant in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.