Active NPI
Matthew Nicholson, DO
- Family Medicine Physician
- Altoona, IA
National Provider Identifier
1760898795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO-04817
- Practice address
- 160 Adventureland Dr NW Ste C
Altoona, IA 50009 - Phone
- (515) 875-9020
- Fax
- (515) 875-9021
- NPI assigned
- Jul 10, 2014
- Last updated
- Jan 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R-10127 | IA | |
| Family Medicine Physician | 207Q00000X | DO-04817 | IA | Primary |
Addresses
Primary practice location
160 Adventureland Dr NW Ste C
Altoona, IA 50009
Mailing address
PO Box 424
Des Moines, IA 50302-0424
Phone (515) 875-9255
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | matthewnicholson@tic.allscriptsdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
160 Adventureland Dr NW
Suite C
Altoona, IA 50009-4232
Phone (515) 875-9100
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-10127 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Iowa Clinic PC | Family Medicine | Current | Accepting new patients |
| The Iowa Clinic, PC | Current | Accepting new patients |
Locations
160 Adventureland Dr NW
Ste C
Altoona, IA 50009
Phone (515) 875-9020
1350 Des Moines St
Ste 110
Des Moines, IA 50309
Phone (515) 358-6500
1005 Pennsylvania Ave
Ste 102A
Ottumwa, IA 52501
Phone (641) 684-2589
7147 Vista Dr
Ste 150
West Des Moines, IA 50266
Phone (515) 875-9255
Interoperability endpoints
- matthewnicholson@tic.allscriptsdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- West Des Moines, IA
- NPI 1871451328
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- West Des Moines, IA
- NPI 1194753863
-
dba Iowa Lutheran Hospital
- General Acute Care Hospital
- Des Moines, IA
- NPI 1356433049
-
dba Iowa Methodist Medical Center
- General Acute Care Hospital
- Des Moines, IA
- NPI 1396837951
-
dba Iowa Methodist Medical Center-Methodist West
- General Acute Care Hospital
- West Des Moines, IA
- NPI 1598905762
-
- Home Health Agency
- Des Moines, IA
- NPI 1801080643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1760898795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 424",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503020424",
"telephone_number": "515-875-9255",
"fax_number": "515-875-9223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 ADVENTURELAND DR NW STE C",
"city": "ALTOONA",
"state": "IA",
"postal_code": "50009",
"telephone_number": "515-875-9020",
"fax_number": "515-875-9021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-10",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "R-10127",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "DO-04817",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "matthewnicholson@tic.allscriptsdirect.net",
"affiliation": "N",
"address_1": "160 Adventureland Dr NW Ste C",
"city": "Altoona",
"state": "IA",
"country_code": "US",
"postal_code": "50009",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Altoona, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.