Matthew Valley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-809 Issued in ID

Practice address

1605 E Riverside Dr
Eagle, ID 83616-6237

Phone

(208) 939-6227

Fax

(208) 939-6442

NPI assigned

Aug 31, 2009

Last updated

Nov 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Keller Skin and Cancer Care PCGroup PAC ID 2769647759, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Keller Skin & Cancer Care PC

  dba Keller Skin Care

  • Dermatology Physician
  • Eagle, ID
  • NPI 1649543323
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1447483086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 E RIVERSIDE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166237",
            "telephone_number": "208-939-6227",
            "fax_number": "208-939-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E RIVERSIDE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166237",
            "telephone_number": "208-939-6227",
            "fax_number": "208-939-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEY",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-31",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-809",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkeller@kellerskin.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "Direct Mail Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1605 E Riverside Dr",
            "city": "Eagle",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836166237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tune Chiropractic Health & Healing P.C.
• Carissa Twitchell
• University Professional Services (University Professional Services in Idaho)
• Erinn Denise Urquiaga, LCPC
• Taylor Valdivia
• Ryan N Van Alfen, DDS, PLC
• Sienna Van Hall
• Ella Miklain Vanalfen
• Emily Verheijen, DPT
• Vibrant Physical Therapy & Wellness

• Medical Physician Assistant in Eagle, ID
• Providers in Eagle, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.