Individual provider Active NPI

Matthew Paul Edwards, P.A.

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1124428644
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004051 Issued in CO
Practice address
2490 W 26TH Ave Ste 300a
Denver, CO 80211-5321
Phone
(303) 831-9393
Fax
(303) 831-6335
NPI assigned
Sep 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004051 CO Primary

Addresses

Primary practice location

2490 W 26TH Ave Ste 300a
Denver, CO 80211-5321

Mailing address

2490 W 26TH Ave Ste 300a
Denver, CO 80211-5321
Phone (303) 831-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20251205002528 CO Practitioner - Physician Assistant 5193218212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0004051COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 5, 2026 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jan 5, 2026 Accepting new patients

Locations

4404 Barranca Ln
Unit 101
Castle Rock, CO 80104
Phone (720) 733-5260

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

4660 Yosemite St
Ste 100
Denver, CO 80238
Phone (720) 516-8900

13631 Colorado Blvd
Thornton, CO 80602
Phone (303) 252-2960

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124428644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVE STE 300A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802115321",
            "telephone_number": "303-831-9393",
            "fax_number": "303-831-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 W 26TH AVE STE 300A",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802115321",
            "telephone_number": "303-831-9393",
            "fax_number": "303-831-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.