Active NPI
Matthew Tyler Pace, PA-C
- Medical Physician Assistant
- Zebulon, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0010-11059
- Practice address
- 1260 N Arendell Ave
Zebulon, NC 27597-8730 - Phone
- (919) 235-1965
- NPI assigned
- Jul 20, 2020
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-11059 | NC | |
| Medical Physician Assistant | 363AM0700X | 0010-11059 | NC | Primary |
Addresses
Primary practice location
1260 N Arendell Ave
Zebulon, NC 27597-8730
Mailing address
PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0351
Other practice location 1
Bldg 5-4257 Bastogne St
Fort Bragg, NC 28303
Phone (919) 235-5574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801404496 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Zotec Way
Carmel, IN 46032-0052
1616 E Millbrook Rd
Suite 110
Raleigh, NC 27609-1924
1616 E Millbrook Rd
Suite 110
Raleigh, NC 27609-4971
1643 NW 136 Ave
Sunrise, FL 33323-2857
PO Box
Charlotte, NC 28260
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-11059 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Emergency Physicians PA | Current | Accepting new patients | |
| Wake Specialty Physicians LLC | Current | Accepting new patients |
Locations
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300
1260 N Arendell Ave
Zebulon, NC 27597
Phone (919) 235-1326
Interoperability endpoints
- mpace536428@directhisp.wakemed.org
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Raleigh, NC
- NPI 1922063387
-
- Surgery Physician
- Raleigh, NC
- NPI 1942440375
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
NC
-
- Emergency Medicine Physician
- Goldsboro, NC
- NPI 1619758018
-
dba WakeMed Childrens Pediatric Primary Care - Fuquay-Varina Medical Park
- Pediatrics Physician
- Fuquay Varina, NC
- NPI 1578334892
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wilson Medical Center
- General Acute Care Hospital
- Wilson, NC
- NPI 1215359922
-
dba Wilson Medical Center
- Psychiatric Hospital Unit
- Wilson, NC
- NPI 1386196459
-
dba Nash General Hospital
- General Acute Care Hospital
- Rocky Mount, NC
- NPI 1619969219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1801404496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602195",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602195",
"telephone_number": "919-350-0351",
"fax_number": "919-350-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 N ARENDELL AVE",
"city": "ZEBULON",
"state": "NC",
"postal_code": "275978730",
"telephone_number": "919-235-1965"
}
],
"practiceLocations": [
{
"address_1": "Bldg 5-4257 Bastogne St",
"address_purpose": "LOCATION",
"city": "Fort Bragg",
"state": "NC",
"postal_code": "28303",
"country_code": "US",
"telephone_number": "919-235-5574",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACE",
"first_name": "MATTHEW",
"middle_name": "TYLER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-20",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-11059",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "0010-11059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1801404496",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Zebulon, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.