Matthew Robert Land, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

4175 S Alamo Ave
Davis Monthan Afb, AZ 85707-4402

Phone

(520) 228-2522

NPI assigned

Feb 14, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1407395213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SIJAN AVE",
            "city": "WHITEMAN AFB",
            "state": "MO",
            "postal_code": "65305",
            "telephone_number": "660-687-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074402",
            "telephone_number": "520-228-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-14",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10287",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetric Jones, OD
• Sherry Lynn Kauffman, LCSW
• Kenneth Karl Knight, MD
• Ryan Charles Knight, PT, DPT, OCS
• Sandra Kay Kuhn, WHNP
• Daniel Cooper Lee Jr., DDS
• Robin L Livingston, DMD
• Payton Lofton, DMD
• Jacob Mack, DMD
• Annetta Rachelle Medaugh, R.N.

• Surgical Physician Assistant in Davis Monthan Afb, AZ
• Providers in Davis Monthan Afb, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.