Individual provider Active NPI

Matthew Albert Wecker, CRNA

  • Certified Registered Nurse Anesthetist
  • Kearney, NE
National Provider Identifier
1497314470
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
101543 Issued in NE
Practice address
804 22ND Ave
Kearney, NE 68845-2206
Phone
(308) 440-3600
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 101543 NE Primary

Addresses

Primary practice location

804 22ND Ave
Kearney, NE 68845-2206

Mailing address

6420 56TH Ave
Kearney, NE 68845-0380
Phone (308) 224-2062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627001985 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113251984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Hospital KearneyGroup PAC ID 5991195547, 116 clinicians

Practice addresses (Care Compare)

816 22ND Ave
Suite 100
Kearney, NE 68845-2226
Phone (308) 865-2263

Hospital & facility affiliations

  • Kearney Regional Medical Center Hospital, Kearney, NE, CCN 280134
  • Gothenburg Health Hospital, Gothenburg, NE, CCN 281313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
101543NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Hospital Kearney CurrentSince Jul 1, 2022 Accepting new patients
Bryan Hospital Kearney CurrentSince Jul 1, 2022 Accepting new patients

Locations

816 22nd Ave
Ste 100
Kearney, NE 68845
Phone (308) 865-2263

804 22nd Ave
Kearney, NE 68845
Phone (308) 455-3600

Organizations & group practices 2

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 2

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1497314470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 56TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688450380",
            "telephone_number": "308-224-2062",
            "fax_number": "888-974-5962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 22ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452206",
            "telephone_number": "308-440-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECKER",
        "first_name": "MATTHEW",
        "middle_name": "ALBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.