Matthew Anthony McQuillan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00023900 Issued in NJ

Practice address

622 Georges Rd
Suite 202
North Brunswick, NJ 08902-3377

Phone

(732) 296-1000

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: matthew.mcquillan.1@31891.direct.athenahealth.com

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1356567713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 HOES LN W",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088548021",
            "telephone_number": "732-235-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 GEORGES RD",
            "address_2": "SUITE 202",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023377",
            "telephone_number": "732-296-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUILLAN",
        "first_name": "MATTHEW",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00023900",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in North Brunswick, NJ
• Providers in North Brunswick, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.