Individual provider Active NPI

Matthew Alexander Cook, FNP

  • Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1346633039
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP10358 Issued in AZ
Practice address
22424 S Ellsworth Loop Rd Unit 1854
Queen Creek, AZ 85142-7293
Phone
(562) 869-8621
NPI assigned
Mar 5, 2015
Last updated
Mar 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP10358 AZ Primary
Family Nurse Practitioner 363LF0000X 95002184 CA

Addresses

Primary practice location

22424 S Ellsworth Loop Rd Unit 1854
Queen Creek, AZ 85142-7293

Mailing address

22424 S Ellsworth Loop Rd Unit 1854
Queen Creek, AZ 85142-7293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 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

Enrollment IDStateProvider typePAC IDDetails
I20150710002360 CA Practitioner - Nurse Practitioner 6204148729 Reassigns benefits to 1 organization
I20171211001702 AZ Practitioner - Nurse Practitioner 6204148729 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10358AZMDNurse Practitioner
95002184CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Jun 7, 2022 Accepting new patients
Dr Carnegie DO a Professional Medical Corporation PastSince Oct 12, 2015 Accepting new patients

Locations

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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, 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": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1346633039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22424 S ELLSWORTH LOOP RD UNIT 1854",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22424 S ELLSWORTH LOOP RD UNIT 1854",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427293",
            "telephone_number": "562-869-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "MATTHEW",
        "middle_name": "ALEXANDER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10358",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.