Individual provider Active NPI

Matthew Armand Bardales, PA-C

  • Physician Assistant
  • Mount Laurel, NJ
National Provider Identifier
1700300647
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00443800 Issued in NJ
Practice address
15000 Midlantic Dr Ste 102
Mount Laurel, NJ 08054-1573
Phone
(856) 255-5479
Fax
(833) 606-0165
NPI assigned
Aug 2, 2017
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00443800 NJ Primary

Addresses

Primary practice location

15000 Midlantic Dr Ste 102
Mount Laurel, NJ 08054-1573

Mailing address

90 Matawan Rd Ste 302
Matawan, NJ 07747-2653
Phone (732) 441-7177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170914002077 NJ Practitioner - Physician Assistant 5294009221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Brain and Spine LLCGroup PAC ID 6608264833, 128 clinicians

Practice addresses (Care Compare)

15000 Midlantic Dr
Suite 102
Mount Laurel, NJ 08054-1573
Phone (856) 255-5479

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
54.35 of 100Reported as group
Quality
27.28
Promoting interoperability
0
Improvement activities
40
Cost
80.29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Brain and Spine LLC CurrentSince Feb 1, 2024 Accepting new patients
Premier Brain and Spine, LLC CurrentSince Feb 1, 2024 Accepting new patients
Freeman Pain Institute PA Physician Assistant Past Accepting new patients

Locations

1801 New Rd
#B
Linwood, NJ 08221

1801 New Rd
Ste C
Linwood, NJ 08221

90 Matawan Rd
Ste 302
Matawan, NJ 07747
Phone (201) 972-5568

15000 Midlantic Dr
Ste 102
Mount Laurel, NJ 08054
Phone (855) 727-2465

329 Greentree Rd
Sewell, NJ 08080
Phone (855) 727-2465

2501 Kuser Rd
Ste 3
Trenton, NJ 08691

2500 Morris Ave
Ste 220
Union, NJ 07083
Phone 7329069600312

1001 Laurel Oak Rd
Ste A2
Voorhees, NJ 08043
Phone (856) 566-8600

Interoperability endpoints

  • Direct secure messaging: matthew.bardales.1@21449.direct.athenahealth.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 5

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1700300647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MATAWAN RD STE 302",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077472653",
            "telephone_number": "732-441-7177",
            "fax_number": "732-441-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 MIDLANTIC DR STE 102",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541573",
            "telephone_number": "856-255-5479",
            "fax_number": "833-606-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDALES",
        "first_name": "MATTHEW",
        "middle_name": "ARMAND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00443800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.