Individual provider Active NPI

Matthew J Amaral, PA-C

  • Physician Assistant
  • Fairhaven, MA
National Provider Identifier
1891342218
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA95289 Issued in MA
Practice address
208 Mill Rd
Fairhaven, MA 02719-5208
Phone
(508) 973-2224
Fax
(508) 973-0394
NPI assigned
Aug 20, 2019
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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 PA95289 MA Primary

Addresses

Primary practice location

208 Mill Rd
Fairhaven, MA 02719-5208

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20231011003329 MA Practitioner - Physician Assistant 7113312000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

101 Page St
New Bedford, MA 02740-3464
Phone (508) 973-5919

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA95289MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Oct 2, 2023 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

208 Mill Rd
Fairhaven, MA 02719
Phone (508) 758-3781

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

1600 11th St
Unit B
Wichita Falls, TX 76301

1631 11th St
Unit B
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: mamaral57823@unitedregional.medalliesdirect.net
  • Direct secure messaging: mamaral71508@direct.southcoast.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 1

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1891342218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195208",
            "telephone_number": "508-973-2224",
            "fax_number": "508-973-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMARAL",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-20",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA95289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhaven, MA

Sources for this page

Verify at the official NPI Registry.