NPIMap

Individual provider Active NPI

Matthew Aaron Williamson, PA

  • Emergency Clinical Nurse Specialist
  • Turlock, CA
National Provider Identifier
1831173111
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Clinical Nurse SpecialistTaxonomy code 364SE0003X
License
PA18033 Issued in CA
Practice address
825 Delbon Ave
Turlock, CA 95382-2016
Phone
(209) 342-2300
Fax
(209) 524-4240
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Clinical Nurse Specialist 364SE0003X PA18033 CA Primary

Addresses

Primary practice location

825 Delbon Ave
Turlock, CA 95382-2016

Mailing address

4301 Northstar Way
Modesto, CA 95356-9262
Phone (209) 342-2300

Other identifiers 1

IdentifierTypeStateIssuer
0PA180330MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20051108000643 CA Practitioner - Physician Assistant 9032137096 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Emergency Medical Group IncGroup PAC ID 2860542479, 24 clinicians
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

1000 Greenley Rd
Sonora, CA 95370-5200
Phone (209) 536-5000

14540 Mono Way
Sonora, CA 95370-8858
Phone (209) 536-6680

23 N Main St
Suite 101
Angels Camp, CA 95222-8001
Phone (209) 736-9130

680 Guzzi LN
Sonora, CA 95370-5288

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as group
Quality
90.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
18033CAMDProfessional Counselor
PA18033CAMDEmergency Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Dec 1, 2023 Accepting new patients
Sonora Community Hospital CurrentSince Jul 18, 2021 Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 1, 2023 Accepting new patients
Sonora Community Hospital CurrentSince Mar 19, 2011 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients
Sonora Community Hospital Past Accepting new patients
Todd C Self, DPM, Inc PastSince Jul 1, 1990 Accepting new patients

Locations

680 Guzzi Ln
Ste 206
Sonora, CA 95370
Phone (209) 536-5760

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

12811 Covey Cir
Sonora, CA 95370
Phone (209) 536-1785

795 Morning Star Dr
Sonora, CA 95370
Phone (209) 533-2545

680 Guzzi Ln
Ste 101
Sonora, CA 95370
Phone (209) 532-9128

680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785

14540 State Highway 108
Sonora, CA 95370
Phone (209) 532-3167

680 Guzzi Ln
Ste 106
Sonora, CA 95370
Phone (209) 532-2792

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

680 Guzzi Ln
Ste 105
Sonora, CA 95370
Phone (209) 532-0126

Organizations & group practices 11

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 12

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1831173111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 NORTHSTAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DELBON AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822016",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MATTHEW",
        "middle_name": "AARON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "CA",
            "license": "PA18033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0PA180330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.