Matthew G Wark, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0004357 Issued in CO

Practice address

711 N Taylor St
Gunnison, CO 81230-2243

Phone

(970) 641-1456

NPI assigned

Feb 27, 2009

Last updated

Mar 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CO, AZ, TX, WA4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.wark.1@11629.direct.athenahealth.com

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.

• Gunnison Valley Hospital

  • Critical Access Hospital
  • Gunnison, CO
  • NPI 1932109048
  Medicare reassignment NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment NPD
• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment
• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352
  Medicare reassignment
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment
• Gunnison Valley Hospital

  dba Gunnison Valley Urgent Care Center

  • Urgent Care Clinic/Center
  • Gunnison, CO
  • NPI 1477361228
  NPD
• Gunnison Valley Hospital

  dba Gunnison Valley Health Family Medicine Clinic

  • Primary Care Clinic/Center
  • Gunnison, CO
  • NPI 1578997284
  NPD
• Gunnison Valley Hospital

  dba Gunnison Valley Orthopedics

  • Orthopaedic Surgery Physician
  • Crested Butte, CO
  • NPI 1942939889
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba SLV Health Conejos County Hospital

  • Critical Access Hospital Clinic/Center
  • La Jara, CO
  • NPI 1194792762
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Stuart Avenue Clinic

  • Internal Medicine Physician
  • Alamosa, CO
  • NPI 1972556744

  Physician Assistant

  NPD

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1720228935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N TAYLOR ST",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302296",
            "telephone_number": "970-641-1456",
            "fax_number": "970-641-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N TAYLOR ST",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302243",
            "telephone_number": "970-641-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARK",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-27",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7541",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.wark.1@11629.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Gunnison Valley Family Medicine Clinic-M Wark",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD Exchange",
            "address_1": "707 N Iowa St",
            "city": "Gunnison",
            "state": "CO",
            "country_code": "US",
            "postal_code": "812302229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmc@direct.slvrmc.org",
            "affiliation": "N",
            "endpointDescription": "San Luis Valley Health ED Matthew Wark",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "106 Blanca Ave",
            "city": "Alamosa",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811012340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathleen Vandervoort-Chapel, RN
• Laura A Villanueva, M.D.
• Jessica Lauren Vogan, LPCC
• Breanna C Vose, PHARMD
• Walmart Inc. (Walmart Pharmacy 10-1550)
• Kelsey Weaver, RN, IBCLC
• Wellness Elevated
• Western Colorado Hearing Clinic
• Western Slope Mental Health PLLC
• Emilie Whittemore, PT

• Physician Assistant in Gunnison, CO
• Providers in Gunnison, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.

Verify at the official NPI Registry.