Matthew Glen Nelson, PA-C
Individual provider Active NPI Physician Assistant · Buhl, ID
NPI 1437584752 · NPPES record last updated Mar 17, 2021
Key facts
- NPI
- 1437584752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA1267 (ID)
- Practice address
- 725 Fair St
Buhl, ID 83316-6442 - Phone
- (208) 543-8271
- Fax
- (208) 543-8272
- NPI assigned
- Sep 5, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Utah School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Health Services Corporation
Practice addresses (Care Compare)
260 3Rd Ave N
Twin Falls, ID 83301-6130
Phone (208) 650-7855
388 Martin St
Twin Falls, ID 83301-4544
Phone (208) 734-0451
401 W Camas
Fairfield, ID 83327-0001
Phone (208) 764-2611
725 Fair St
Buhl, ID 83316-6442
Phone (208) 543-8271
Hospital & facility affiliations
- St Lukes Magic Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150901001866 | ID | Practitioner - Physician Assistant | 0840425898 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1267 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Services Corporation | Physician Assistant | Current | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Current | Accepting new patients |
| Family Health Services Corporation | Current |
Accepting new patients | |
| Family Health Services Corporation | Current | Accepting new patients | |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Past | Accepting new patients | |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Physician Assistant | Past | Accepting new patients |
| Family Health Services Corporation | Past | Accepting new patients |
Locations
621 N Main St
Bellevue, ID 83313
Phone (208) 725-3145
725 Fair St
Buhl, ID 83316
Phone (208) 543-8271
1309 Bennett Ave
Burley, ID 83318
Phone (208) 677-5198
114 Pioneer Ct
Jerome, ID 83338
Phone (208) 324-3471
218 W Nez Perce
Jerome, ID 83338
Phone (208) 324-3471
402 6th St
Rupert, ID 83350
Phone (208) 650-7941
651 S Beverly St
Shoshone, ID 83352
Phone (208) 886-2224
794 Eastland Dr
Twin Falls, ID 83301
Phone (208) 734-3312
325 Martin St
Twin Falls, ID 83301
Phone (208) 732-7101
388 Martin St
Twin Falls, ID 83301
Phone (208) 734-0451
Interoperability endpoints
- matthew.nelson.p1@direct.fhsid.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1267 | ID | Yes |
Addresses
Primary practice location
725 Fair St
Buhl, ID 83316-6442
Mailing address
794 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 737-6718
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437584752 | Other | UT | EMI HEALTH |
| 148464 | Other | UT | PEHP |
| P01239491 | Other | UT | RAILROAD MEDICARE |
| 5606757 | Other | UT | AETNA HEALTHCARE |
Other providers in Buhl, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.