Matthew Jacob Nelson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-10913 Issued in ID

Practice address

1907 S Broadway Ave Ste 101
Boise, ID 83706-4229

Phone

(208) 345-1222

Fax

(208) 345-1261

NPI assigned

Jun 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, MP2 enrollments

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 2

Specialty

Family Practice

Education

Saint Louis University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Healthcare CorporationGroup PAC ID 7719075167, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Commonwealth Health Center Hospital, Garapan, MP, CCN 660001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Commonwealth Healthcare Corporation

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saipan, MP
  • NPI 1285858290
  Medicare reassignment Care Compare group NPD
• Medical Associates of the Pacific LLC

  • Internal Medicine Physician
  • Saipan, MP
  • NPI 1144310723
  Medicare reassignment NPD
• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  NPD

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

• Commonwealth Healthcare Corporation

  • General Acute Care Hospital
  • Saipan, MP
  • NPI 1871616292
  Care Compare affiliation

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1669633798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500",
            "fax_number": "208-955-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S BROADWAY AVE STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837064229",
            "telephone_number": "208-345-1222",
            "fax_number": "208-345-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MATTHEW",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-10913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808083100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Michael Nelson
• Kinsey Elora Nelson, LPC
• Kristi Nelson, MA
• Lisa M Nelson, M.D.
• Matthew Alex Nelson, LMT, CMA, MFA
• Matthew Ryan Nelson, MD
• Meaghan Elizabeth Nelson, PA
• Meghan Nelson, LCSW
• Ryan Richard Nelson
• Sharon Nelson, RD, LD

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.