Individual provider Active NPI

Aubrey Matthiesen

  • Nurse Practitioner
  • Clinton, IA
National Provider Identifier
1861043010
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A156062 Issued in IA
Practice address
915 13TH Ave N
Clinton, IA 52732-5099
Phone
(563) 519-1905
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A156062 IA Primary

Addresses

Primary practice location

915 13TH Ave N
Clinton, IA 52732-5099

Mailing address

609 Williams St
Grand Mound, IA 52751-9512
Phone (563) 357-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20200115000150 IA Practitioner - Nurse Practitioner 7618302928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Specialty ClinicGroup PAC ID 3375639586, 65 clinicians

Practice addresses (Care Compare)

1410 N 4TH St
Clinton, IA 52732-2940
Phone (563) 244-5900

915 13TH Ave N
Mercyone Clinton Plaza
Clinton, IA 52732-5067
Phone (563) 243-2511

Hospital & facility affiliations

  • Genesis Vna Home health agency, Bettendorf, IA, CCN 167012
  • Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156062IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Specialty Clinic CurrentSince Dec 16, 2019 Accepting new patients
Mercy Specialty Clinic Current Accepting new patients
Medical Associates of Clinton, Iowa P.L.C. Current Accepting new patients
Mercy Specialty Clinic CurrentSince Dec 16, 2019 Accepting new patients

Locations

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

621 S Illinois Ave
Ste 103
Mason City, IA 50401

Interoperability endpoints

  • Direct secure messaging: aubrey.matthiesen@macmc.eclinicaldirectplus.com
  • Direct secure messaging: amatthiesen4172128@direct.trinity-health.org

Organizations & group practices 4

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 2

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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1861043010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 WILLIAMS ST",
            "city": "GRAND MOUND",
            "state": "IA",
            "postal_code": "527519512",
            "telephone_number": "563-357-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325099",
            "telephone_number": "563-519-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHIESEN",
        "first_name": "AUBREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A156062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

Verify at the official NPI Registry.