Individual provider Active NPI

Matthew Wetmore, AUD

  • Audiologist
  • Surprise, AZ
National Provider Identifier
1568950459
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA10639 Issued in AZ
Practice address
14757 W Mountain View Blvd Ste 120
Surprise, AZ 85374-2704
Phone
(623) 227-1924
Fax
(623) 738-3913
NPI assigned
Apr 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA10639 AZ Primary

Addresses

Primary practice location

14757 W Mountain View Blvd Ste 120
Surprise, AZ 85374-2704

Mailing address

8877 W Union Hills Dr Ste 350
Peoria, AZ 85382-3026
Phone (623) 428-0727

Other practice location 1

8877 W Union Hills Dr Ste 350
Peoria, AZ 85382-3026
Phone (623) 428-0727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125002318 AZ Practitioner - Qualified Audiologist 2567709777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Happy Ears Hearing CenterGroup PAC ID 5890001325, 5 clinicians

Practice addresses (Care Compare)

14757 W Mountain View Blvd
Suite 120
Surprise, AZ 85374-2704
Phone (623) 227-1924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Hearcare Network, Inc PastSince Jun 1, 2018 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1568950459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8877 W UNION HILLS DR STE 350",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823026",
            "telephone_number": "623-428-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14757 W MOUNTAIN VIEW BLVD STE 120",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-227-1924",
            "fax_number": "623-738-3913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8877 W Union Hills Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853823026",
            "country_code": "US",
            "telephone_number": "623-428-0727",
            "fax_number": "623-738-3918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA10639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.