Matthew Thomas Carr

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2632 Issued in ID

Practice address

211 Forest St
McCall, ID 83638-5256

Phone

(208) 634-2225

Fax

(208) 634-7212

NPI assigned

Dec 12, 2023

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic - McCall LLCGroup PAC ID 7618127994, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's McCall Hospital, McCall, ID, CCN 131312
• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006
• Cascade Medical Center Hospital, Cascade, ID, CCN 130779

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• St Lukes Clinic - McCall LLC

  dba St Lukes Clinic - McCall

  • Family Medicine Physician
  • McCall, ID
  • NPI 1881982510
  Medicare reassignment Care Compare group
• St Lukes McCall, LTD

  dba St Lukes McCall Clinics

  • Family Medicine Physician
  • McCall, ID
  • NPI 1336457738

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cascade Medical Center Hospital District

  • Rural Acute Care Hospital
  • Cascade, ID
  • NPI 1689720435
  Care Compare affiliation
• St Lukes McCall LTD

  • Critical Access Hospital
  • McCall, ID
  • NPI 1235447970
  Care Compare affiliation
• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1629846423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FOREST ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836385256",
            "telephone_number": "208-634-2225",
            "fax_number": "208-634-7212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9887 W Barnsdale Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837042102",
            "country_code": "US",
            "telephone_number": "208-954-2309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brundage Mountain Resort, LLC
• David G. Burica, MD
• Ingrid A Burica, PT
• Angela Butti, NP
• Jennifer Jane Caple, LCSW
• Wendy Carson
• Laura Celentano
• Central Idaho Counseling, PLLC (Central Idaho Counseling)
• Central Mountains Counseling, PLLC
• Carissa Ellen Chamberlain, CPM, LM

• Physician Assistant in McCall, ID
• Providers in McCall, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.