Active NPI
Matthew Alan Radel, PA
- Medical Physician Assistant
- Gig Harbor, WA
National Provider Identifier
1710174164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA60178573
- Practice address
- 11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812 - Phone
- (253) 530-2100
- NPI assigned
- Oct 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA01269 | OR | |
| Medical Physician Assistant | 363AM0700X | PA60178573 | WA | Primary |
Addresses
Primary practice location
11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Mailing address
505 S 336TH St Ste 600
Federal Way, WA 98003-5947
Phone (800) 336-8614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA01269 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Physician Associates, Apc | Past | Accepting new patients |
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1710174164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S 336TH ST STE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980035947",
"telephone_number": "800-336-8614",
"fax_number": "253-838-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11567 CANTERWOOD BLVD NW",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983325812",
"telephone_number": "253-530-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADEL",
"first_name": "MATTHEW",
"middle_name": "ALAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-01",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA01269",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60178573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gig Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.