NPIMap

Individual provider Active NPI

Matthew John Pyrch, PA-C

  • Medical Physician Assistant
  • Longview, WA
National Provider Identifier
1801128715
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 60131088 Issued in WA
Practice address
1706 Washington Way
Longview, WA 98632-2952
Phone
(360) 423-9580
Fax
(360) 423-6230
NPI assigned
Feb 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 60131088 WA Primary

Addresses

Primary practice location

1706 Washington Way
Longview, WA 98632-2952

Mailing address

PO Box 1338
Longview, WA 98632-7785
Phone (360) 423-9580

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpyrch231615@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130306000432 OR Practitioner - Physician Assistant 2860524790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9437
Phone (503) 215-9900

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 60131088WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jan 7, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 7, 2013 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Organizations & group practices 4

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 4

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": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1801128715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1338",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986327785",
            "telephone_number": "360-423-9580",
            "fax_number": "360-423-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 WASHINGTON WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322952",
            "telephone_number": "360-423-9580",
            "fax_number": "360-423-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYRCH",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA 60131088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpyrch231615@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 NE 99th Ave Ste 100",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.