Individual provider Active NPI

Matthew James Hewetson, PA-C

  • Physician Assistant
  • Clinton, NC
National Provider Identifier
1891588125
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15657 Issued in NC
Practice address
412 E Johnson St
Clinton, NC 28328-2806
Phone
(910) 490-1240
Fax
(910) 490-1260
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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 0010-15657 NC Primary

Addresses

Primary practice location

412 E Johnson St
Clinton, NC 28328-2806

Mailing address

412 E Johnson St
Clinton, NC 28328-2806
Phone (910) 490-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20251011000142 NC Practitioner - Physician Assistant 7911494208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glass Dermatology PLLCGroup PAC ID 6608270632, 3 clinicians

Practice addresses (Care Compare)

412 E Johnson St
Clinton, NC 28328-2806
Phone (910) 490-1240

412 E Johnston St
Clinton, NC 28328-2806

National Provider Directory

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

Organizations & group practices 1

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1891588125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E JOHNSON ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282806",
            "telephone_number": "910-490-1240",
            "fax_number": "910-490-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E JOHNSON ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282806",
            "telephone_number": "910-490-1240",
            "fax_number": "910-490-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWETSON",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.