Individual provider Active NPI

Matthew Ryan Nelson, MD

  • Cardiovascular Disease Physician
  • Boise, ID
National Provider Identifier
1376622985
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
M-13641 Issued in ID
Practice address
6140 W Curtisian
Ste 200
Boise, ID 83704
Phone
(208) 302-0000
Fax
(208) 302-0055
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006-01754 NC
Cardiovascular Disease Physician 207RC0000X M-13641 ID Primary
Cardiovascular Disease Physician 207RC0000X 37891 AZ
Cardiovascular Disease Physician 207RC0000X 12422 ND

Addresses

Primary practice location

6140 W Curtisian
Ste 200
Boise, ID 83704

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 302-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170405002209 ID Practitioner - Cardiovascular Disease (Cardiology) 6204908023 Reassigns benefits to 1 organization
I20170616001240 OR Practitioner - Cardiovascular Disease (Cardiology) 6204908023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Iowa, RJ & L Carver College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, shared by 4 NPIs, 672 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

323 E Riverside Dr
Suite 224
Eagle, ID 83616-6865
Phone (208) 302-6000

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7000

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

4424 E Flamingo Ave
Nampa, ID 83687-9306

6140 W Curtisian Ave
Boise, ID 83704-0107
Phone (208) 302-0000

6140 W Curtisian Ave
Boise, ID 83704-0109

645 E 5TH St
Weiser, ID 83672-2202
Phone (208) 549-0370

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St. Alphonsus Medical Center - Baker City Hospital, Baker City, OR, CCN 381315
  • Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01754NCMDInternal Medicine Physician
12422NDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc Internal Medicine CurrentSince Oct 12, 2022 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc Cardiovascular Disease CurrentSince May 1, 2017 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince May 1, 2017 Accepting new patients

Locations

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

6140 W Curtisian Ave
Ste 100
Boise, ID 83704
Phone (208) 367-4224

6140 W Curtisian Ave
Ste 2
Boise, ID 83704

6140 W Curtisian Ave
Ste 200
Boise, ID 83704
Phone (208) 363-9074

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

4424 E Flamingo Ave
Ste 300
Nampa, ID 83687
Phone (208) 302-0200

3175 Pocahontas Rd
Baker City, OR 97814
Phone (208) 302-2200

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

1050 SW 3rd Ave
Ste 1800
Ontario, OR 97914

1050 SW 3rd Ave
Ste 1600
Ontario, OR 97914
Phone (541) 881-2360

Interoperability endpoints

  • Direct secure messaging: mnelson1564113@direct.trinity-health.org

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.

Hospital & facility affiliations 12

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1376622985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-0000",
            "fax_number": "208-302-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 W CURTISIAN",
            "address_2": "STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-302-0000",
            "fax_number": "208-302-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006-01754",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-13641",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "37891",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ND",
            "license": "12422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.