Individual provider Active NPI

Matthew Hubbard

  • Medical Physician Assistant
  • Greeley, CO
National Provider Identifier
1457085995
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA0008719 Issued in CO
Practice address
1010 A St
Greeley, CO 80631-2021
Phone
(970) 313-0400
NPI assigned
Jul 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA0008719 CO Primary

Addresses

Primary practice location

1010 A St
Greeley, CO 80631-2021

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 391-7887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240903001282 CO Practitioner - Physician Assistant 6103365200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Community HealthGroup PAC ID 0648164780, 51 clinicians

Practice addresses (Care Compare)

100 N 11TH Ave
Greeley, CO 80631-2011
Phone (970) 352-8898

1010 A St
Greeley, CO 80631-2021
Phone (970) 313-0400

302 3Rd St SE
Suite 150
Loveland, CO 80537-6419
Phone (970) 669-4855

Hospital & facility affiliations

  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0008719COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Sep 9, 2024 Accepting new patients
Sunrise Community Health Past Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

1010 A St
Greeley, CO 80631
Phone (970) 313-0400

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Interoperability endpoints

  • Direct secure messaging: matthew.hubbard.1@27043.direct.athenahealth.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 12

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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1457085995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-391-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 A ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806312021",
            "telephone_number": "970-313-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-11",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0008719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.