NPIMap

Individual provider Active NPI

Matthew Joseph Maida, PA-C

  • Medical Physician Assistant
  • Dunmore, PA
National Provider Identifier
1689712259
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051016 Issued in PA
Practice address
1100 Meade St
Dunmore, PA 18512-3169
Phone
(570) 342-3675
Fax
(570) 496-6417
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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 MA051016 PA
Medical Physician Assistant 363AM0700X MA051016 PA Primary

Addresses

Primary practice location

1100 Meade St
Dunmore, PA 18512-3169

Mailing address

1100 Meade St
Dunmore, PA 18512-3169
Phone (570) 342-3675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040803000506 PA Practitioner - Physician Assistant 9739150897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

703 Martin F Gibbons Blvd
Dickson City, PA 18519-1784
Phone (570) 846-2340

Hospital & facility affiliations

  • Wayne Memorial Hospital Hospital, Honesdale, PA, CCN 390125
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051016PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Feb 1, 2013 Accepting new patients
Geisinger Clinic CurrentSince Feb 1, 2013 Accepting new patients
Professional Emergency Care, PC Physician Assistant Past Accepting new patients
Geisinger Clinic Past Accepting new patients
General and Vascular Surgical Associates of North Jersey, P.a. Past Accepting new patients
Community Medical Care, Inc Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1740 E Broad St
Hazleton, PA 18201
Phone (570) 459-2901

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

10 Trieble Dr
Tunkhannock, PA 18657
Phone (570) 836-2273

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: mmaida84206@direct.geisinger.edu

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1689712259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MEADE ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-342-3675",
            "fax_number": "570-496-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MEADE ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123169",
            "telephone_number": "570-342-3675",
            "fax_number": "570-496-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIDA",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051016",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.