Individual provider Active NPI

Matthew David Halverson, NP

  • Adult Health Nurse Practitioner
  • Gloucester, MA
National Provider Identifier
1508976341
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
250337 Issued in MA
Practice address
292 Washington St
Seacoast Nursing and Rehabilitation Center
Gloucester, MA 01930-4832
Phone
(978) 716-3600
Fax
(978) 716-3669
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 250337 MA Primary

Addresses

Primary practice location

292 Washington St
Seacoast Nursing and Rehabilitation Center
Gloucester, MA 01930-4832

Mailing address

35 Stockholm Ave
Rockport, MA 01966-1254
Phone (978) 994-6383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040810001225 MA Practitioner - Nurse Practitioner 7719959725 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

75 Brimbal Ave
Beverly, MA 01915-6009
Phone (978) 977-2577

900 Cummings Ctr
Suite 218U
Beverly, MA 01915-6103
Phone (978) 922-3622

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
S.R. Amesbury, M.D., P.C. Past Accepting new patients

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1508976341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 STOCKHOLM AVE",
            "city": "ROCKPORT",
            "state": "MA",
            "postal_code": "019661254",
            "telephone_number": "978-994-6383",
            "fax_number": "978-309-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 WASHINGTON ST",
            "address_2": "SEACOAST NURSING AND REHABILITATION CENTER",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019304832",
            "telephone_number": "978-716-3600",
            "fax_number": "978-716-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "250337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.