Individual provider Active NPI

Matthew Applegate, ACNP

  • Acute Care Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1821461070
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP129439 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 407
Tyler, TX 75701-1952
Phone
(903) 592-4460
NPI assigned
Nov 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP129439 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 407
Tyler, TX 75701-1952

Mailing address

700 Olympic Plaza Cir Ste 407
Tyler, TX 75701-1952
Phone (903) 592-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151203003006 TX Practitioner - Nurse Practitioner 6406156090 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Oct 15, 2018 Accepting new patients
Union Emergency Physicians, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 15, 2018 Accepting new patients
Acute Care Specialists CurrentSince Mar 17, 2021 Accepting new patients
Northeast Texas Emergency Physicians, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Oct 15, 2018 Accepting new patients
Tyler Regional Hospital LLC PastSince Oct 21, 2015 Accepting new patients

Locations

1007 S William St
Atlanta, TX 75551
Phone (903) 614-2000

323 E Hawkins Pkwy
Longview, TX 75605
Phone (903) 315-2000

1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365

4250 Gibson Ln
Texarkana, TX 75503
Phone (903) 614-8100

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

5505 New Copeland Rd
Tyler, TX 75703
Phone (903) 521-9861

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

Interoperability endpoints

  • Direct secure messaging: mapplegate115024@christushealth.direct-ci.net

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1821461070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 407",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011952",
            "telephone_number": "903-592-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 407",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011952",
            "telephone_number": "903-592-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLEGATE",
        "first_name": "MATTHEW",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP129439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.