Individual provider Active NPI

Matthew J Roesner, PA-C

  • Physician Assistant
  • Crete, NE
National Provider Identifier
1760830335
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2016 Issued in NE
Practice address
2910 Betten Dr
Crete, NE 68333-3084
Phone
(402) 826-2102
NPI assigned
May 24, 2016
Last updated
May 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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 2016 NE Primary

Addresses

Primary practice location

2910 Betten Dr
Crete, NE 68333-3084

Mailing address

PO Box 220
Crete, NE 68333-0220
Phone (402) 826-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160629000335 NE Practitioner - Physician Assistant 2163713702 Reassigns benefits to 2 organizations
I20170223000548 IA Practitioner - Physician Assistant 2163713702 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Auburn Family Health Center PCGroup PAC ID 4385749191, 14 clinicians

Practice addresses (Care Compare)

2115 14TH St
Suite 100
Auburn, NE 68305-1760
Phone (402) 274-4993

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salahuddin Syed MD PC Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Aug 20, 2017 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Aug 20, 2017 Accepting new patients
Clarinda Regional Health Center CurrentSince May 29, 2020 Accepting new patients
Alegent Creighton Clinic Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients

Locations

220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1760830335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683330220",
            "telephone_number": "402-826-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BETTEN DR",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683333084",
            "telephone_number": "402-826-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESNER",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

Verify at the official NPI Registry.