Individual provider Active NPI

Matthew S. Lemieux, CPNP-PC

  • Pediatric Nurse Practitioner
  • Fishersville, VA
National Provider Identifier
1710363718
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024172835 Issued in VA
Practice address
57 Beam LN Ste 202
Fishersville, VA 22939-2350
Phone
(540) 932-0980
Fax
(540) 932-0979
NPI assigned
Aug 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 0024172835 VA
Pediatric Nurse Practitioner 363LP0200X 0024172835 VA Primary

Addresses

Primary practice location

57 Beam LN Ste 202
Fishersville, VA 22939-2350

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-2350
Phone (434) 924-0211

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlemieux113330@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20151221000548 VA Practitioner - Nurse Practitioner 9436450285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

57 Beam LN
Suite 202
Fishersville, VA 22939-2350
Phone (540) 932-0980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Aug 25, 2017 Accepting new patients
Jha MD PC PastSince Aug 25, 2017 Accepting new patients

Locations

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

57 Beam Ln
Ste 202
Fishersville, VA 22939
Phone (540) 932-0980

Interoperability endpoints

  • Direct secure messaging: mlemieux113330@direct.healthsystem.virginia.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1710363718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEAM LN STE 202",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392350",
            "telephone_number": "540-932-0980",
            "fax_number": "540-932-0979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082350",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMIEUX",
        "first_name": "MATTHEW",
        "middle_name": "S.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-03",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "VA",
            "license": "0024172835",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024172835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlemieux113330@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "57 Beam Ln Ste 202",
            "city": "Fishersville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229392350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.