Matthew J Weaver, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110004159 Issued in VA

Practice address

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453

Phone

(540) 741-0555

NPI assigned

Mar 14, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Mission Wound Care Virginia PLLCGroup PAC ID 9739629494, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Old Mission Wound Care Virginia PLLC

  • Specialist
  • Traverse City, MI
  • NPI 1255170627

  VA

  Medicare reassignment Care Compare group
• Fredericksburg Emergency Medical Alliance, Inc.

  • Emergency Medicine Physician
  • Fredericksburg, VA
  • NPI 1396779153
  Medicare reassignment
• Stafford Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Stafford, VA
  • NPI 1477582773
  Medicare reassignment
• Stafford Primary Care Associates, Inc.

  • Specialist
  • Stafford, VA
  • NPI 1871522177
  NPD

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1831430974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SAM PERRY BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SAM PERRY BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014453",
            "telephone_number": "540-741-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110004159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Waters
• Jordan Watkins, PHARMD
• Vicki Ann Watson, NP
• Waves of Grace Counseling, LLC
• We Care 4 U Support Services
• David Kevin Weber, M.D.
• Laura Kathleen Weber, MED, SLP
• Timothy D Weber, MD
• Courtney Lee Webster
• Fernanda Regina Webster, LPC

• Physician Assistant in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.

Verify at the official NPI Registry.