Matthew Clark Jenison, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

430637 Issued in NY

Practice address

50 Leroy St
Potsdam, NY 13676-1786

Phone

(315) 265-3300

NPI assigned

May 23, 2012

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 NY, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rutherford Regional Medical Center Hospital, Rutherfordton, NC, CCN 340013
• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  NC

  Medicare reassignment Care Compare group NPD
• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Medicare reassignment NPD
• Canton-Potsdam Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potsdam, NY
  • NPI 1114104445
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Rutherford Regional Health System, LLC

  • General Acute Care Hospital
  • Rutherfordton, NC
  • NPI 1245321181
  Care Compare affiliation
• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1285994202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENISON",
        "first_name": "MATTHEW",
        "middle_name": "CLARK",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "430637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Jeffery Jackson, PA
• Jubin Jacob, MD
• James Huang Physician PLLC
• Eboni Christina January, M.D.
• Amber Jarrett, R.N.
• Bernadette Lori Jenkins, OPTICIAN
• Stacie Jessmer, PTA
• Zachary Philip Johannesson, MD
• Melissa Jo Johnson, PHARMD
• Amy Jones, LPN

• Acute Care Nurse Practitioner in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.