Active NPI
Matthew D Garris, PA-C
- Physician Assistant
- Blair, NE
National Provider Identifier
1376610097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 900
- Practice address
- 407 S. 19TH St
Blair, NE 68008 - Phone
- (402) 533-2223
- Fax
- (531) 301-6272
- NPI assigned
- Nov 29, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 900 | NE | |
| Physician Assistant | 363A00000X | 900 | NE | Primary |
Addresses
Primary practice location
407 S. 19TH St
Blair, NE 68008
Mailing address
407 S. 19TH St
Blair, NE 68008
Phone (402) 533-2223
Other practice location 1
515 N 162nd Ave Ste 303
Omaha, NE 68118-2540
Phone (402) 354-5860
Other practice location 2
8303 Dodge St Ste 225
Omaha, NE 68114-4108
Phone (402) 354-5860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38785 | Other | NE | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140326000834 | NE | Practitioner - Physician Assistant | 1355572827 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Community Hospital Corporation
Practice addresses (Care Compare)
4929 County Rd
P43
Fort Calhoun, NE 68023-5066
Phone (402) 468-4655
810 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-2182
812 N 22ND St
Blair, NE 68008-1128
Phone (402) 426-4611
Hospital & facility affiliations
- Memorial Community Hospital & Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 900 | NE | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Community Hospital Corporation | Current | Accepting new patients |
Locations
810 N 22nd St
Blair, NE 68008
Phone (402) 426-1116
812 N 22nd St
Blair, NE 68008
Phone (402) 426-4611
4929 County Road P43
Fort Calhoun, NE 68023
Phone (402) 426-1629
Organizations & group practices 6
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.
-
- Rural Health Clinic/Center
- Fort Calhoun, NE
- NPI 1417015207
-
- Medicare Defined Swing Bed Hospital Unit
- Blair, NE
- NPI 1548391709
-
- Rural Health Clinic/Center
- Blair, NE
- NPI 1922166453
-
- Rural Health Clinic/Center
- Tekamah, NE
- NPI 1952487589
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646870400000",
"number": "1376610097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 S. 19TH ST",
"city": "BLAIR",
"state": "NE",
"postal_code": "68008",
"telephone_number": "402-533-2223",
"fax_number": "531-301-6272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S. 19TH ST",
"city": "BLAIR",
"state": "NE",
"postal_code": "68008",
"telephone_number": "402-533-2223",
"fax_number": "531-301-6272"
}
],
"practiceLocations": [
{
"address_1": "515 N 162nd Ave Ste 303",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681182540",
"country_code": "US",
"telephone_number": "402-354-5860",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8303 Dodge St Ste 225",
"address_purpose": "LOCATION",
"city": "Omaha",
"state": "NE",
"postal_code": "681144108",
"country_code": "US",
"telephone_number": "402-354-5860",
"fax_number": "402-354-2350",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARRIS",
"first_name": "MATTHEW",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2022-03-10",
"certification_date": "2022-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NE",
"license": "900",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "900",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "38785",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blair, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.