Active NPI
Matthew Thomas Thimling, PA-C
- Medical Physician Assistant
- Indianapolis, IN
National Provider Identifier
1891132809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 10001621A
- Practice address
- 4151 E 96TH St
Indianapolis, IN 46240-1442 - Phone
- (866) 434-3255
- NPI assigned
- May 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Medical Physician Assistant | 363AM0700X | 10001621A | IN | Primary |
Addresses
Primary practice location
4151 E 96TH St
Indianapolis, IN 46240-1442
Mailing address
4151 E 96TH St
Indianapolis, IN 46240-1442
Phone (866) 434-3255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200079040C | Other | IN | MEDICAID GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10001621A | IN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1891132809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4151 E 96TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462401442",
"telephone_number": "866-434-3255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4151 E 96TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462401442",
"telephone_number": "866-434-3255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIMLING",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-30",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IN",
"license": "10001621A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP",
"identifier": "200079040C",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.