Active NPI
Matthew David Williams, PA-C
- Physician Assistant
- Summit, NJ
National Provider Identifier
1144749359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00493000
- Practice address
- 99 Beauvoir Avenue
Carol G. Simon Cancer Center
Summit, NJ 07901 - Phone
- (908) 608-0078
- NPI assigned
- Sep 19, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 021184-1 | NY | |
| Physician Assistant | 363A00000X | 25MP00493000 | NJ | Primary |
Addresses
Primary practice location
99 Beauvoir Avenue
Carol G. Simon Cancer Center
Summit, NJ 07901
Mailing address
77 Brant Ave Ste 200
Clark, NJ 07066-1540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596
1000 Galloping Hill Rd
Union, NJ 07083-7989
Phone (908) 598-6655
Hospital & facility affiliations
- Overlook Medical Center
- Morristown Medical Center
- Chilton Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021184-1 | NY | MD | Physical Therapist |
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.
-
- Internal Medicine Physician
- Morristown, NJ
- NPI 1427016385
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Morristown, NJ
- NPI 1053384776
-
- General Acute Care Hospital
- Summit, NJ
- NPI 1740254143
-
- General Acute Care Hospital
- Pompton Plains, NJ
- NPI 1811994809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1144749359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 BRANT AVE STE 200",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 BEAUVOIR AVENUE",
"address_2": "CAROL G. SIMON CANCER CENTER",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "07901",
"telephone_number": "908-608-0078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-19",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "021184-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00493000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Summit, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.