Individual provider Active NPI

Matthew Timothy James Luce

  • Family Nurse Practitioner
  • Longview, WA
National Provider Identifier
1144748815
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60911371 Issued in WA
Practice address
812 Ocean Beach Hwy Ste 200
Longview, WA 98632-4082
Phone
(360) 636-6900
NPI assigned
Sep 1, 2017
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN60002190 WA
Family Nurse Practitioner 363LF0000X AP60911371 WA Primary

Addresses

Primary practice location

812 Ocean Beach Hwy Ste 200
Longview, WA 98632-4082

Mailing address

23709A NE 50TH Ave
Battle Ground, WA 98604-4070
Phone (360) 901-9788

Other practice location 1

23709A NE 50th Ave
Battle Ground, WA 98604-4070
Phone (360) 901-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190117000344 WA Practitioner - Nurse Practitioner 4587900253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

1660 Delware St
Longview, WA 98632-2310
Phone (360) 414-2800

Hospital & facility affiliations

  • Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60002190WAMDEmergency Registered Nurse
AP60911371WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 6, 2019 Accepting new patients

Locations

812 Ocean Beach Hwy
Ste 200
Longview, WA 98632
Phone (360) 501-3547

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • Direct secure messaging: mluce8159@direct.peacehealth.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144748815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23709A NE 50TH AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044070",
            "telephone_number": "360-901-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 OCEAN BEACH HWY STE 200",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324082",
            "telephone_number": "360-636-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23709A NE 50th Ave",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986044070",
            "country_code": "US",
            "telephone_number": "360-901-9788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCE",
        "first_name": "MATTHEW",
        "middle_name": "TIMOTHY JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60002190",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60911371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.