Individual provider Active NPI

Molly Anne Matthews, PAC

  • Medical Physician Assistant
  • Medford, OR
National Provider Identifier
1891124970
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA205662
Practice address
2900 State St
Medford, OR 97504-8458
Phone
(541) 789-5790
Fax
(541) 789-5973
NPI assigned
Nov 8, 2013
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA205662 Primary
Medical Physician Assistant 363AM0700X PA0003834 CO

Addresses

Primary practice location

2900 State St
Medford, OR 97504-8458

Mailing address

2825 E Barnett Rd # MSS
Medford, OR 97504-8332
Phone (541) 789-4281

Other practice location 1

499 E Hampden Ave
Ste 220
Englewood, CO 80113-2780
Phone (303) 783-8844

Other practice location 2

2825 E Barnett Rd # Mss
Medford, OR 97504-8332
Phone (541) 789-4281

Other identifiers 2

IdentifierTypeStateIssuer
PA0003834OtherCOCOLORADO LICENSE
PA205662OtherOROREGON MEDICAL BOARD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmatthews85351@direct.dhha.org Health Information Exchange (HIE)
Direct Messaging Address Molly.matthews@asante.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161229001478 CO Practitioner - Physician Assistant 5890076053 Reassigns benefits to 1 organization
I20210817003125 OR Practitioner - Physician Assistant 5890076053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

2900 State St
Suite 101
Medford, OR 97504-8475
Phone (541) 789-5790

625 SW Ramsey Ave
Suite a
Grants Pass, OR 97527-5808
Phone (541) 507-2290

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0003834COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Dec 8, 2016 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 8, 2016 Accepting new patients
App Neurology Clinic Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

Interoperability endpoints

  • Direct secure messaging: mmatthews85351@direct.dhha.org
  • Direct secure messaging: molly.matthews@asante.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1891124970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E BARNETT RD # MSS",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048458",
            "telephone_number": "541-789-5790",
            "fax_number": "541-789-5973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "499 E Hampden Ave",
            "address_2": "Ste 220",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "CO",
            "postal_code": "801132780",
            "country_code": "US",
            "telephone_number": "303-783-8844",
            "fax_number": "303-783-2002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2825 E Barnett Rd # Mss",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048332",
            "country_code": "US",
            "telephone_number": "541-789-4281",
            "fax_number": "541-789-4806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "MOLLY",
        "middle_name": "ANNE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "PA205662",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA0003834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO LICENSE",
            "identifier": "PA0003834",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAL BOARD",
            "identifier": "PA205662",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmatthews85351@direct.dhha.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Molly.matthews@asante.org",
            "affiliation": "N",
            "address_1": "2825 E Barnett Rd # Mss",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975048332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.