Individual provider Active NPI

Matthew E Noll, PA-C

  • Physician Assistant
  • Auburn, NY
National Provider Identifier
1629554860
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022219 Issued in NY
Practice address
17 Lansing St
Auburn, NY 13021-1983
Phone
(315) 255-7011
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022219 NY Primary
Physician Assistant 363A00000X 22219 NY

Addresses

Primary practice location

17 Lansing St
Auburn, NY 13021-1983

Mailing address

17 Lansing St
Auburn, NY 13021-1983
Phone (315) 255-7011

Other practice location 1

1000 South Ave
Rochester, NY 14620-2782
Phone (585) 473-2200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mnoll115005@direct.urmc.rochester.edu Direct
Direct Messaging Address mnoll115005@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190918001961 NY Practitioner - Physician Assistant 6608106679 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Memorial Medical Services PCGroup PAC ID 6406931385, 121 clinicians

Practice addresses (Care Compare)

17 Lansing St
Suite 302
Auburn, NY 13021-1983
Phone (315) 567-0540

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.84 of 100Reported as group
Quality
68.36
Promoting interoperability
100
Improvement activities
40
Cost
81.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22219NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Hospital of Rochester CurrentSince Dec 31, 2022 Accepting new patients
Highland Hospital of Rochester CurrentSince Jul 24, 2019 Accepting new patients
Highland Hospital of Rochester CurrentSince Jul 24, 2019 Accepting new patients
Auburn Community Hospital CurrentSince Jul 26, 2025 Accepting new patients
Auburn Community Hospital CurrentSince Jul 26, 2025 Accepting new patients

Locations

17 Lansing St
Ste 302
Auburn, NY 13021
Phone (315) 567-0540

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

1000 South Ave
Rochester, NY 14620
Phone (585) 341-0366

1000 South Ave
#58
Rochester, NY 14620
Phone (585) 341-6776

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

Interoperability endpoints

  • Direct secure messaging: mnoll115005@direct.urmc.rochester.edu
  • Direct secure messaging: mnoll@amms.medentdirect.com

Organizations & group practices 7

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 1

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1629554860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LANSING ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211983",
            "telephone_number": "315-255-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 South Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146202782",
            "country_code": "US",
            "telephone_number": "585-473-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLL",
        "first_name": "MATTHEW",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022219",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "22219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnoll115005@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnoll115005@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.