NPIMap

Individual provider Active NPI

Matthew Gregory West, PA

  • Physician Assistant
  • Fallon, NV
National Provider Identifier
1811248933
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0419 Issued in NV
Practice address
50 Commercial Way
Fallon, NV 89406-2600
Phone
(775) 455-4254
Fax
(775) 242-4591
NPI assigned
Sep 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1381 NV
Physician Assistant 363A00000X PA0419 NV Primary

Addresses

Primary practice location

50 Commercial Way
Fallon, NV 89406-2600

Mailing address

50 Commercial Way
Fallon, NV 89406-2600
Phone (775) 455-4254

Other practice location 1

1025 Hospital Road
Schurz, NV 89427
Phone (775) 773-2005

Other identifiers 2

IdentifierTypeStateIssuer
12436250OtherCAQH
1811248933MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121211000525 NV Practitioner - Physician Assistant 9032361449 Reassigns benefits to 2 organizations
I20250602001395 TX Practitioner - Physician Assistant 9032361449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Walker River Paiute TribeGroup PAC ID 9133565203, 3 clinicians

Practice addresses (Care Compare)

PO Box C
Schurz, NV 89427

PO Box C
Schurz, NV 89427-0502

Hospital & facility affiliations

  • Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0419NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians West LLC CurrentSince Feb 1, 2018 Accepting new patients
Mt Grant General Hospital CurrentSince Mar 8, 2014 Accepting new patients
Walker River Paiute Tribe CurrentSince Apr 28, 2025 Accepting new patients
Banner Health Physicians West LLC CurrentSince Feb 1, 2018 Accepting new patients

Locations

801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310

801 E Williams Ave
Ste 2207
Fallon, NV 89406
Phone (775) 428-2747

Organizations & group practices 9

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": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1811248933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 COMMERCIAL WAY",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062600",
            "telephone_number": "775-455-4254",
            "fax_number": "775-242-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 COMMERCIAL WAY",
            "city": "FALLON",
            "state": "NV",
            "postal_code": "894062600",
            "telephone_number": "775-455-4254",
            "fax_number": "775-242-4591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Hospital Road",
            "address_purpose": "LOCATION",
            "city": "Schurz",
            "state": "NV",
            "postal_code": "89427",
            "country_code": "US",
            "telephone_number": "775-773-2005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "MATTHEW",
        "middle_name": "GREGORY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-28",
        "last_updated": "2024-10-03",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1381",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12436250",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811248933",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallon, NV

Sources for this page

Verify at the official NPI Registry.