Individual provider Active NPI

Matthew Thomson, PA-C

  • Physician Assistant
  • Evanston, WY
National Provider Identifier
1386121986
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
195 Feather Way
Evanston, WY 82930-9352
Phone
(307) 789-0096
NPI assigned
Jul 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

195 Feather Way
Evanston, WY 82930-9352

Mailing address

195 Feather Way
Evanston, WY 82930-9352
Phone (307) 789-0096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181212002322 WY Practitioner - Physician Assistant 5395080782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Lincoln County Hospital DistrictGroup PAC ID 4789580218, 66 clinicians

Practice addresses (Care Compare)

10764 N US Hwy 30
Cokeville, WY 83114
Phone (307) 885-5970

110 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5852

120 Hospital LN
Afton, WY 83110-9409
Phone (307) 885-5870

195 Feather Way
Evanston, WY 82930-9352
Phone (307) 789-0096

Hospital & facility affiliations

  • Star Valley Medical Center Hospital, Afton, WY, CCN 531313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Lincoln Hospital District CurrentSince Sep 22, 2018 Accepting new patients
North Lincoln County Hospital District CurrentSince Aug 7, 2023 Accepting new patients
South Lincoln Hospital District CurrentSince Sep 22, 2018 Accepting new patients
North Lincoln County Hospital District CurrentSince Aug 7, 2023 Accepting new patients

Locations

110 Hospital Ln
Afton, WY 83110
Phone (208) 227-1137

901 Adams St
Afton, WY 83110
Phone (307) 885-5800

195 Feather Way
Evanston, WY 82930
Phone (307) 200-9200

190 Arrowhead Dr
Evanston, WY 82930
Phone (307) 789-3636

195 Overthrust Rd
Evanston, WY 82930
Phone (307) 444-3600

711 Onyx St
Kemmerer, WY 83101
Phone (307) 877-4401

Interoperability endpoints

  • Direct secure messaging: mthomson644641@direct.ochin.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 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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1386121986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FEATHER WAY",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309352",
            "telephone_number": "307-789-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FEATHER WAY",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829309352",
            "telephone_number": "307-789-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

Verify at the official NPI Registry.