Individual provider Active NPI

Matthew Calvin Nelson

  • Pediatrics Physician
  • Danville, PA
National Provider Identifier
1508280132
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS018623 Issued in PA
Practice address
16 Woodbine LN
Danville, PA 17821-8029
Phone
(570) 271-5600
Fax
(570) 271-5851
NPI assigned
Feb 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS018623 PA Primary

Addresses

Primary practice location

16 Woodbine LN
Danville, PA 17821-8029

Mailing address

100 North Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnelson116497@direct.geisinger.edu Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170829000383 PA Practitioner - Pediatric Medicine 0143524462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS018623PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 2, 2017 Accepting new patients
Geisinger Clinic CurrentSince Jul 2, 2017 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Past Accepting new patients
Geisinger Bloomsburg Hospital Past Accepting new patients
Geisinger Medical Center Past Accepting new patients

Locations

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

100 N Academy Ave
Danville, PA 17822

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

Interoperability endpoints

  • Direct secure messaging: mnelson116497@direct.geisinger.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1508280132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WOODBINE LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178218029",
            "telephone_number": "570-271-5600",
            "fax_number": "570-271-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "CALVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS018623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnelson116497@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16 Woodbine Ln",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178218029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.