Matthew James Dolan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4493-23 Issued in WI

Practice address

1726 Shawano Ave
Green Bay, WI 54303

Phone

(414) 290-6720

Fax

(414) 290-6755

NPI assigned

Jul 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Merit-based Incentive Payment System (MIPS)

Final score

84.74 of 100Reported as group

Quality

73.23

Improvement activities

40

Cost

82.42

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vituity-Wisconsin Em SC

  • Emergency Medicine Physician
  • Pleasant Prairie, WI
  • NPI 1326730664
  Medicare reassignment
• Door County Memorial Hospital

  • Critical Access Hospital
  • Sturgeon Bay, WI
  • NPI 1093743874
  NPD
• Door County Memorial Hospital

  • Rural Health Clinic/Center
  • Sturgeon Bay, WI
  • NPI 1326748104
  NPD
• Vituity-Wisconsin Em SC

  • Emergency Medicine Physician
  • Sheboygan, WI
  • NPI 1902673478
  NPD

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1215423504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE STE 2000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024809",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54303",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Van Buren St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013526",
            "country_code": "US",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4493-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Robert Dobson, DO
• Pamela G Dobson, DO
• Kim Doell
• Alyssa Rose Doherty, NP
• Carrie Eve Doine, O.T.R.
• Traci L Dolski, OTR
• Kenneth Dombrowski
• Carrie Dominiczak, SACIT
• Megan Domnick
• Breyan Donath-Skeen

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.

Verify at the official NPI Registry.