Individual provider Active NPI

Matthew Gregson, PA-C

  • Physician Assistant
  • Pocatello, ID
National Provider Identifier
1710358007
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1151 Hospital Way BLDG a
Pocatello, ID 83201-5091
Phone
(208) 232-6616
Fax
(208) 232-6618
NPI assigned
Oct 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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 Primary

Addresses

Primary practice location

1151 Hospital Way BLDG a
Pocatello, ID 83201-5091

Mailing address

1151 Hospital Way, BLDG a
Pocatello, ID 83201-5091
Phone (208) 232-6616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20151228002052 ID Practitioner - Physician Assistant 3678874187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Hospital LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince Sep 1, 2017 Accepting new patients
Endoscopy Center, LLC Past Accepting new patients

Locations

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Ste 201
Pocatello, ID 83201
Phone (208) 239-2260

1151 Hospital Way
Bldg A
Pocatello, ID 83201
Phone (208) 232-6616

Interoperability endpoints

  • Direct secure messaging: mgregson179512@ahs.direct-ci.com

Organizations & group practices 4

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 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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1710358007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY, BLDG A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015091",
            "telephone_number": "208-232-6616",
            "fax_number": "208-232-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 HOSPITAL WAY BLDG A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015091",
            "telephone_number": "208-232-6616",
            "fax_number": "208-232-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGSON",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.