Individual provider Active NPI

Matthew Michael Musulin, M.D.

  • Neurology Physician
  • Rocky Mount, NC
National Provider Identifier
1669546040
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2007-00621 Issued in NC
Practice address
901 N Winstead Ave
Rocky Mount, NC 27804-8467
Phone
(252) 937-0289
Fax
(252) 937-3114
NPI assigned
Nov 20, 2006
Last updated
Jul 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2007-00621 NC Primary

Addresses

Primary practice location

901 N Winstead Ave
Rocky Mount, NC 27804-8467

Mailing address

PO Box 7200
Rocky Mount, NC 27804-0200
Phone (252) 937-0200

Other identifiers 2

IdentifierTypeStateIssuer
14475OtherNCBCBSNC
5906464MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000522 NC Practitioner - Neurology 1557462579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Kentucky College of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Comprehensive Rehab of Wilson, Inc.Group PAC ID 2668377375, 115 clinicians
Boice-Willis Clinic PAGroup PAC ID 0143122382, 58 clinicians

Practice addresses (Care Compare)

1811 Forest Hills Rd W
Wilson, NC 27893-3412
Phone (252) 243-7400

901 N Winstead Ave
Rocky Mount, NC 27804-8712
Phone (252) 937-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boice-Willis Clinic PA Neurology CurrentSince Jun 1, 2007 Accepting new patients
Boice-Willis Clinic, PA CurrentSince Jun 1, 2007 Accepting new patients

Locations

901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200

901 N Winstead Ave
Ste 260
Rocky Mount, NC 27804
Phone (252) 210-6530

921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300

Interoperability endpoints

  • Direct secure messaging: matthew.musulin@bwc.eclinicaldirectplus.com

Organizations & group practices 3

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 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1669546040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0200",
            "fax_number": "252-451-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0289",
            "fax_number": "252-937-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSULIN",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2007-00621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "14475",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906464",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.