Individual provider Active NPI

Matthew T. Van Hoosen, PA

  • Physician Assistant
  • Fishers, IN
National Provider Identifier
1275251357
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003666A Issued in IN
Practice address
13100 E 136TH St Ste 2000
Fishers, IN 46037-9440
Phone
(317) 688-5980
NPI assigned
Aug 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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 10003666A IN Primary

Addresses

Primary practice location

13100 E 136TH St Ste 2000
Fishers, IN 46037-9440

Mailing address

13100 E 136TH St Ste 2000
Fishers, IN 46037-9440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220922001208 IN Practitioner - Physician Assistant 9931584281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

13000 E 136TH St
Fishers, IN 46037-9478
Phone (317) 678-2000

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

13100 E 136th St
Ste 2000
Fishers, IN 46037
Phone (317) 688-5980

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: mvanhoosen@direct.iuhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1275251357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13100 E 136TH ST STE 2000",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 E 136TH ST STE 2000",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379440",
            "telephone_number": "317-688-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HOOSEN",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003666A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.