Individual provider Active NPI

Matthew Paul Van Tine, PA-C

  • Physician Assistant
  • Hershey, PA
National Provider Identifier
1447468590
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2026035237 Issued in MO
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(800) 243-1455
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA066837 PA
Physician Assistant 363A00000X 2026035237 MO Primary
Physician Assistant 363A00000X C0003493 MD
Physician Assistant 363A00000X 1437 NE

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr MC Ca410
Hershey, PA 17033-2360
Phone (717) 531-5208

Other practice location 1

4239 Farnam St Ste 100
Omaha, NE 68131-2858
Phone (402) 552-2320

Other practice location 2

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

Other names 1

  • Matthew P Van Tine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20140717001905 DC Practitioner - Physician Assistant 3476602871 Reassigns benefits to 1 organization
I20171013000797 MD Practitioner - Physician Assistant 3476602871 Reassigns benefits to 1 organization
I20250811000559 PA Practitioner - Physician Assistant 3476602871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1437NEMDSocial Worker
C0003493MDMDPhysician Assistant
MA066837PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 18, 2025 Accepting new patients
Inova Health Care Services CurrentSince May 1, 2014 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Sep 25, 2017 Accepting new patients
Inova Health Care Services CurrentSince May 1, 2014 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Sep 25, 2017 Accepting new patients
The Milton S Hershey Medical Center Physcian Group CurrentSince Aug 18, 2025 Accepting new patients
The Nebraska Medical Center Past Accepting new patients
Nebraska Medical Center Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 35
Baltimore, MD 21215
Phone (410) 601-0900

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

500 University Dr
#41
Hershey, PA 17033
Phone (717) 531-8202

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

8503 Arlington Blvd
Fairfax, VA 22031
Phone (703) 970-2670

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Organizations & group practices 10

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1447468590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-5208",
            "fax_number": "717-531-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-243-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4239 Farnam St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681312858",
            "country_code": "US",
            "telephone_number": "402-552-2320",
            "fax_number": "402-552-2330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-617-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN TINE",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066837",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2026035237",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003493",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "VAN TINE",
            "middle_name": "P",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.