Individual provider Active NPI

Matthew Sean Loftus, PA

  • Physician Assistant
  • Glens Falls, NY
National Provider Identifier
1417948852
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007722 Issued in NY
Practice address
100 Park St
Glens Falls Hospital Hospitalist Program
Glens Falls, NY 12801-4413
Phone
(518) 926-5925
Fax
(518) 926-5917
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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 007722 NY Primary

Addresses

Primary practice location

100 Park St
Glens Falls Hospital Hospitalist Program
Glens Falls, NY 12801-4413

Mailing address

100 Park Street
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801-4413
Phone (518) 926-6992

Other identifiers 2

IdentifierTypeStateIssuer
02347946MedicaidNY
P00007685OtherNYRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address m.loftus@cdirectglensfallshosp.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100217000277 NY Practitioner - Physician Assistant 2860536646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000

79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612

Hospital & facility affiliations

  • Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.44
Promoting interoperability
97.95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007722NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc CurrentSince Nov 12, 2000 Accepting new patients
Glens Falls Hospital Inc Past Accepting new patients

Locations

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

Interoperability endpoints

  • Direct secure messaging: mloftus95410@albanymed.direct-ci.com

Organizations & group practices 3

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1417948852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-6992",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK ST",
            "address_2": "GLENS FALLS HOSPITAL HOSPITALIST PROGRAM",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-5925",
            "fax_number": "518-926-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTUS",
        "first_name": "MATTHEW",
        "middle_name": "SEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02347946",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00007685",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "m.loftus@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "100 Park St",
            "address_2": "Glens Falls Hospital Hospitalist Program",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.