John F Matista, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10004886 Issued in WA

Practice address

1330 Rockefeller Ave
Suite 225
Everett, WA 98201-1684

Phone

(425) 261-4910

Fax

(425) 261-4911

NPI assigned

Aug 29, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Public Hospital Dist No 1 Skagit

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment
• Public Hospital Dist No 1 Skagit

  • Obstetrics & Gynecology Physician
  • Arlington, WA
  • NPI 1073554903
  NPD
• Public Hospital Dist No 1 Skagit

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Everett Cardiology & Electrophysiology, P.S.

  • Cardiovascular Disease Physician
  • Everett, WA
  • NPI 1528266103
  NPD (past)

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1366435943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "SUITE 225",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4910",
            "fax_number": "425-261-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "SUITE 225",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4910",
            "fax_number": "425-261-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATISTA",
        "first_name": "JOHN",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004886",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004886",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8435968",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberley Ann Mathers
• Lee Matheson
• Carly Denise Mathews
• Tiffany Lynn Mathias Fielder, MD
• Stephen John Mathias, MA, RC
• Heidi Matlack
• Karl Frederic Matous, IDC
• Samantha Annette Matras
• Emily Matson, CMA
• Monica Matt, RPH

• Medical Physician Assistant in Everett, WA
• Providers in Everett, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.