Individual provider Active NPI

Matthew Willard, APRN

  • Acute Care Nurse Practitioner
  • Westerly, RI
National Provider Identifier
1821577594
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN01876 Issued in RI
Practice address
45 Wells St Ste 204
Westerly, RI 02891-2927
Phone
(401) 637-7929
NPI assigned
Aug 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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 APRN01876 RI Primary

Addresses

Primary practice location

45 Wells St Ste 204
Westerly, RI 02891-2927

Mailing address

PO Box 1119
Providence, RI 02901-1119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20181026000577 RI Practitioner - Nurse Practitioner 7315290012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Hospital & facility affiliations

  • Westerly Hospital Hospital, Westerly, RI, CCN 410013

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN01876RIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Orthopedics, Inc. CurrentSince Dec 7, 2019 Accepting new patients
University Orthopedics, Inc. CurrentSince Dec 7, 2019 Accepting new patients

Locations

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

593 Eddy St
Providence, RI 02903

45 Wells St
Ste 204
Westerly, RI 02891
Phone (401) 315-5595

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 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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1821577594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WELLS ST STE 204",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912927",
            "telephone_number": "401-637-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "MATTHEW",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "APRN01876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.