NPIMap

Individual provider Active NPI

Matthew Rosenberger, PAC

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1427099613
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004204 Issued in WA
Practice address
206 S 11TH Ave Ste 48
Yakima, WA 98902-3205
Phone
(509) 575-5058
Fax
(509) 575-5196
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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 PA10004204 WA Primary

Addresses

Primary practice location

206 S 11TH Ave Ste 48
Yakima, WA 98902-3205

Mailing address

1814 Greenway
#B
Yakima, WA 98902-5223
Phone (509) 985-7778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804001126 WA Practitioner - Physician Assistant 6608805114 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thuthi Enterprises LLCGroup PAC ID 3870903099, 7 clinicians

Practice addresses (Care Compare)

715 N Park Ctr
Selah, WA 98942-1174
Phone (509) 698-2624

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thuthi Enterprises, LLC CurrentSince Dec 1, 2020 Accepting new patients
Washington Em-I Medical Services PC Physician Assistant Past Accepting new patients
Yakima Emergency Group a Professional Limited Liability Com Physician Assistant Past Accepting new patients
Columbia Valley Emergency Physicians LLC Physician Assistant Past Accepting new patients
Yakima Hma Physician Management LLC Past Accepting new patients

Locations

715 North Park Ctr
Ste A
Selah, WA 98942
Phone (509) 426-2378

715 North Park Ctr
Ste B
Selah, WA 98942
Phone (509) 426-2378

715 North Park Ctr
Selah, WA 98942
Phone (206) 794-8710

Interoperability endpoints

  • Direct secure messaging: matthew.rosenberger.1@22275.direct.athenahealth.com

Organizations & group practices 9

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1427099613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 GREENWAY",
            "address_2": "#B",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025223",
            "telephone_number": "509-985-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S 11TH AVE STE 48",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023205",
            "telephone_number": "509-575-5058",
            "fax_number": "509-575-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERGER",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.