Active NPI
Matthew Wetherell
- Geriatric Medicine (Family Medicine) Physician
- Worcester, MA
National Provider Identifier
1134624042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 292061
- Practice address
- 288 Grove St
Worcester, MA 01605-3934 - Phone
- (508) 856-9650
- NPI assigned
- Mar 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 292061 | MA | Primary |
Addresses
Primary practice location
288 Grove St
Worcester, MA 01605-3934
Mailing address
288 Grove St
Worcester, MA 01605-3934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250318001642 | MA | Order and Referring Only - Family Practice | 2668994815 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- matthew.wetherell.p1@direct.fallonhealth.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1134624042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 GROVE ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "288 GROVE ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016053934",
"telephone_number": "508-856-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETHERELL",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-25",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "MA",
"license": "292061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.