Active NPI
Matthew Allen Hussong, AGNP-C
- Gerontology Nurse Practitioner
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 71010218A
- Practice address
- 7150 Clearvista Dr
Indianapolis, IN 46256-1695 - Phone
- (317) 621-4900
- NPI assigned
- Jul 13, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28213561A | IN | |
| Gerontology Nurse Practitioner | 363LG0600X | 311191 | NY | |
| Gerontology Nurse Practitioner | 363LG0600X | 71010218A | IN | Primary |
Addresses
Primary practice location
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Mailing address
575 Lexington Ave
New York, NY 10022-6102
Phone (212) 746-1664
Other practice location 1
525 E 68th St
New York, NY 10065-4870
Phone (212) 746-1664
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | mah4038@direct.nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7979 N Shadeland Ave
Indianapolis, IN 46250-2042
Phone (317) 621-4418
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28213561A | IN | MD | Registered Nurse |
| 311191 | NY | MD | Diagnostic Radiology Physician |
| 71010218A | IN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Weill Medical College of Cornell | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Weill Medical College of Cornell | Current | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
7979 N Shadeland Ave
Ste 300
Indianapolis, IN 46250
Phone (317) 621-4418
7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041
525 E 68th St
New York, NY 10065
Phone (212) 746-2846
Interoperability endpoints
- mhussong125418@ecommunitydirect.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
-
- Geriatric Medicine (Internal Medicine) Physician
- New York, NY
- NPI 1831100882
-
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
-
- Cardiovascular Disease Physician
- New York, NY
- NPI 1144729385
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1336119478
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1619163854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1366060691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 LEXINGTON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100226102",
"telephone_number": "212-746-1664",
"fax_number": "212-746-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7150 CLEARVISTA DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561695",
"telephone_number": "317-621-4900"
}
],
"practiceLocations": [
{
"address_1": "525 E 68th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100654870",
"country_code": "US",
"telephone_number": "212-746-1664",
"fax_number": "212-746-4888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUSSONG",
"first_name": "MATTHEW",
"middle_name": "ALLEN",
"credential": "AGNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-13",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28213561A",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NY",
"license": "311191",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IN",
"license": "71010218A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "525 E 68th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100654870",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "525 E 68th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100654870",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mah4038@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "525 E 68th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100654870",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.