NPIMap

Individual provider Active NPI

Matthew Mastiano

  • Medical Physician Assistant
  • Chambersburg, PA
National Provider Identifier
1154953545
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA062515 Issued in PA
Practice address
12 St Paul Drive
Wellspan Neurosurgery
Chambersburg, PA 17201
Phone
(717) 217-6028
NPI assigned
Feb 4, 2020
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2511 WV
Physician Assistant 363A00000X C007902 MD
Physician Assistant 363A00000X MA062515 PA
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X MA062515 PA Primary

Addresses

Primary practice location

12 St Paul Drive
Wellspan Neurosurgery
Chambersburg, PA 17201

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA, WV3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210503001595 MD Practitioner - Physician Assistant 2860801933 Reassigns benefits to 1 organization
I20210812001231 PA Practitioner - Physician Assistant 2860801933 Reassigns benefits to 1 organization
I20210813000485 WV Practitioner - Physician Assistant 2860801933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

112 N 7TH St
Chambersburg, PA 17201-1720
Phone (717) 267-7164

12 St Paul Dr
Chambersburg, PA 17201-1035

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2511WVMDProfessional Counselor
C007902MDMDPhysician Assistant
MA062515PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Apr 25, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Apr 25, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Apr 25, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

17 Western Maryland Pkwy
Ste 100
Hagerstown, MD 21740
Phone (301) 797-6389

12 St Paul Dr
Chambersburg, PA 17201
Phone (717) 217-6026

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: mmastiano273371@wellspan.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1154953545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DRIVE",
            "address_2": "WELLSPAN NEUROSURGERY",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "17201",
            "telephone_number": "717-217-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTIANO",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2511",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C007902",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062515",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA062515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.