NPIMap

Individual provider Active NPI

Matthew Bezzant, PA-C

  • Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1578873774
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
522 Issued in WY
Practice address
2970 N Main St
Las Cruces, NM 88001-1152
Phone
(575) 525-3531
Fax
(575) 525-3534
NPI assigned
Oct 21, 2010
Last updated
Sep 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 522 WY Primary

Addresses

Primary practice location

2970 N Main St
Las Cruces, NM 88001-1152

Mailing address

2970 N Main St
Las Cruces, NM 88001-1152
Phone (575) 525-3531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.bezzant.2@1928.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151016000262 NM Practitioner - Physician Assistant 8729274832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3015 Memorial CT
Las Cruces, NM 88011-9127
Phone (575) 556-1860

4351 E Lohman Ave
Suite 200
Las Cruces, NM 88011-8260
Phone (505) 532-9755

4351 E Lohman Ave
Suite 403
Las Cruces, NM 88011-8261
Phone (575) 522-6806

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
522NDMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Las Cruces Physician Practices LLC CurrentSince Aug 1, 2021 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Aug 1, 2021 Accepting new patients
Las Cruces Physician Practices, LLC Physician Assistant Past Accepting new patients
Familycare Associates,PA Past Accepting new patients

Locations

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: matthew.bezzant.1@19849.direct.athenahealth.com
  • Direct secure messaging: matthew.bezzant.2@1928.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1578873774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 N MAIN ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011152",
            "telephone_number": "575-525-3531",
            "fax_number": "575-525-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 N MAIN ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011152",
            "telephone_number": "575-525-3531",
            "fax_number": "575-525-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZZANT",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.bezzant.2@1928.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "2970 N Main St",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880011152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.