Individual provider Active NPI

Matthew George Styles

  • Physician Assistant
  • Colton, CA
National Provider Identifier
1174922496
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 N Pepper Ave
Mob, Ste#107
Colton, CA 92324-1801
Phone
(909) 580-4289
Fax
(909) 580-1388
NPI assigned
Aug 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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 Primary

Addresses

Primary practice location

400 N Pepper Ave
Mob, Ste#107
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Mob, Ste#107
Colton, CA 92324-1801
Phone (909) 580-4289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150210000012 CA Practitioner - Physician Assistant 3072838325 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52063CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Dec 1, 2014 Accepting new patients
Cep America Past Accepting new patients
Cep-America, Osa Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1174922496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "MOB, STE#107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-4289",
            "fax_number": "909-580-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "MOB, STE#107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-4289",
            "fax_number": "909-580-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYLES",
        "first_name": "MATTHEW",
        "middle_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.