Active NPI
Matthew Daniel Phillips, PA-C
- Physician Assistant
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA- 1469
- Practice address
- 1055 N Curtis Road
Boise, ID 83706 - Phone
- (208) 367-7350
- Fax
- (208) 367-3951
- NPI assigned
- Feb 8, 2017
- Last updated
- Nov 16, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA- 1469 | ID | Primary |
Addresses
Primary practice location
1055 N Curtis Road
Boise, ID 83706
Mailing address
3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 367-7350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121
3025 W Cherry LN
Meridian, ID 83642-8531
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA- 1469 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Physician Assistant | Current | Accepting new patients |
Locations
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342
Interoperability endpoints
- mphillips1564283@direct.trinity-health.org
Organizations & group practices 2
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.
-
- Psychologist
- Boise, ID
- NPI 1649357716
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Physician Assistant
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Saint Alphonsus RMC TVL
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
dba St Alphonsus Rehabilitation Services
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510790400000",
"number": "1326586413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3340 E GOLDSTONE WAY",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "83642",
"telephone_number": "208-367-7350",
"fax_number": "208-367-3951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N CURTIS ROAD",
"city": "BOISE",
"state": "ID",
"postal_code": "83706",
"telephone_number": "208-367-7350",
"fax_number": "208-367-3951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MATTHEW",
"middle_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-08",
"last_updated": "2017-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA- 1469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.