Matthew P Walters, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

51649-20 Issued in WI

Practice address

2845 Greenbrier Road
Green Bay, WI 54311

Phone

(920) 288-4746

Fax

(920) 288-4737

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Medical College of Wisconsin, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Pathologists SCGroup PAC ID 7315850682, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193
• Aurora Medical Ctr Manitowoc County Hospital, Two Rivers, WI, CCN 520034
• Aurora Medical Center Sheboygan County Hospital, Sheboygan, WI, CCN 520035
• Aurora Medical Ctr Oshkosh Hospital, Oshkosh, WI, CCN 520198
• Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Great Lakes Pathologists SC

  • Anatomic Pathology & Clinical Pathology Physician
  • West Allis, WI
  • NPI 1689695934
  Medicare reassignment Care Compare group NPD
• A2Cl Services, LLC

  • Clinical Medical Laboratory
  • West Allis, WI
  • NPI 1710064811
  NPD

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

• Aurora Health Care Central, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sheboygan, WI
  • NPI 1902023955

  Hospital

  Care Compare affiliation
• Aurora Health Care Central, Inc.

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1922053107
  Care Compare affiliation
• Aurora Health Care North, Inc.

  • General Acute Care Hospital
  • Two Rivers, WI
  • NPI 1477508687
  Care Compare affiliation
• Aurora Medical Center Bay Area, Inc

  • General Acute Care Hospital
  • Marinette, WI
  • NPI 1043397177
  Care Compare affiliation
• Aurora Medical Center Bay Area, Inc

  • Clinical Medical Laboratory
  • Marinette, WI
  • NPI 1083791115

  Hospital

  Care Compare affiliation
• Aurora Medical Center Bay Area, Inc

  • Land Ambulance
  • Marinette, WI
  • NPI 1427135557

  Hospital

  Care Compare affiliation
• Aurora Medical Center of Oshkosh, Inc

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1275578064
  Care Compare affiliation
• Baycare Aurora, LLC

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1255387726
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1497835862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-288-4746",
            "fax_number": "920-288-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-288-4746",
            "fax_number": "920-288-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MATTHEW",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "53509",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "104878",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "51649-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwalters14934@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2845 Greenbrier Road",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Road",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Caitlin Wall
• Michael James Wallace, DDS
• Alyssa Ruth Waller
• Walter J. Ratschan, M.D., S.C.
• Heather Walters
• Trisha Ann Walton, APNP
• Jacqueline Wanezek, D.D.S.
• Dan Wang, DDS
• Qiang Wang, MD
• Wei-Chuan Wang, MD

• Anatomic Pathology & Clinical Pathology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.