Individual provider Active NPI

Matthew Davel, PA

  • Physician Assistant
  • Oshkosh, WI
National Provider Identifier
1740913359
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8473-23 Issued in WI
Practice address
855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone
(920) 303-8700
NPI assigned
Jul 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 8473-23 WI Primary

Addresses

Primary practice location

855 N Westhaven Dr
Oshkosh, WI 54904-7668

Mailing address

855 N Westhaven Dr
Oshkosh, WI 54904-7668

Other identifiers 1

IdentifierTypeStateIssuer
100373238MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service Other Ability Network
Direct Messaging Address mdavel150841@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20251002000482 WI Practitioner - Physician Assistant 1153827712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8473-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Single Specialty CurrentSince Oct 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Single Specialty CurrentSince Oct 1, 2025 Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Interoperability endpoints

  • Direct secure messaging: mdavel150841@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 1

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1740913359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047668",
            "telephone_number": "920-303-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVEL",
        "first_name": "MATTHEW",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8473-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100373238",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/Documentsubmission/2_0/Nhinservice/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavel150841@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.