Individual provider Active NPI

Matthew Paul Parker, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1861903809
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4315 E Main St
Mesa, AZ 85205-8605
Phone
(480) 870-7500
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4315 E Main St
Mesa, AZ 85205-8605

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (615) 314-8069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20171201001965 AZ Practitioner - Physician Assistant 5799042529 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6930AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC CurrentSince May 26, 2022 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince May 26, 2022 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

13055 W McDowell Rd
Ste E109
Avondale, AZ 85392
Phone (623) 328-7794

13657 W McDowell Rd
Ste 118
Goodyear, AZ 85395
Phone (623) 328-7794

1003 Division St
Ste 8
Prescott, AZ 86301
Phone (928) 515-0804

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Interoperability endpoints

  • Direct secure messaging: mparker@hmg.gwaydirect.com

Organizations & group practices 5

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1861903809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "615-314-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058605",
            "telephone_number": "480-870-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.