Individual provider Active NPI

Matthew J. Hrvatin, PA-C

  • Physician Assistant
  • Goose Creek, SC
National Provider Identifier
1235725631
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3834 Issued in SC
Practice address
7 S Alliance Dr Ste 211B
Goose Creek, SC 29445-7297
Phone
(843) 553-4383
Fax
(843) 553-4384
NPI assigned
Dec 19, 2020
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 3834 SC Primary

Addresses

Primary practice location

7 S Alliance Dr Ste 211B
Goose Creek, SC 29445-7297

Mailing address

PO Box 530062
Atlanta, GA 30353-0062
Phone (843) 695-6071

Other practice location 1

1054 Anna Knapp Blvd Apt 7F
Mount Pleasant, SC 29464-3166
Phone (330) 853-0712

Other identifiers 1

IdentifierTypeStateIssuer
4495PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210323001453 SC Practitioner - Physician Assistant 4486061280 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3834SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 8, 2021 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Mar 8, 2021 Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

7 S Alliance Dr
Ste 211B
Goose Creek, SC 29445
Phone (843) 553-4383

201 Sigma Dr
Ste 100
Summerville, SC 29486
Phone (843) 820-3397

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1608336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1235725631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530062",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530062",
            "telephone_number": "843-695-6071",
            "fax_number": "843-569-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 S ALLIANCE DR STE 211B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457297",
            "telephone_number": "843-553-4383",
            "fax_number": "843-553-4384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 Anna Knapp Blvd Apt 7F",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643166",
            "country_code": "US",
            "telephone_number": "330-853-0712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HRVATIN",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-19",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4495PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

Verify at the official NPI Registry.