Individual provider Active NPI

Matthew Kenneth Walker

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1902390222
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
309629 Issued in LA
Practice address
8080 Bluebonnet Blvd Ste 1000
Baton Rouge, LA 70810-7827
Phone
(225) 924-2424
Fax
(225) 408-7984
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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 309629 LA Primary

Addresses

Primary practice location

8080 Bluebonnet Blvd Ste 1000
Baton Rouge, LA 70810-7827

Mailing address

8080 Bluebonnet Blvd Ste 1000
Baton Rouge, LA 70810-7827
Phone (225) 924-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20180719002613 LA Practitioner - Physician Assistant 2668729716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCP Urgent Care Holdings LLCGroup PAC ID 5092016816, 47 clinicians

Practice addresses (Care Compare)

14879 Tiger Bend Rd
Baton Rouge, LA 70817-4618
Phone (225) 257-7782

17513 Old Jefferson Hwy
Prairieville, LA 70769-3930
Phone (225) 673-7587

2840 Florida St
Baton Rouge, LA 70802-2721
Phone (225) 224-2402

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PCP Urgent Care Holdings LLC CurrentSince Nov 15, 2021 Accepting new patients
PCP Urgent Care Holdings LLC CurrentSince Nov 15, 2021 Accepting new patients
R.T. Royal Group LLC PastSince Jul 28, 2019 Accepting new patients

Locations

9688 Florida Blvd
Baton Rouge, LA 70815
Phone (225) 408-7587

8540 Siegen Ln
Ste B
Baton Rouge, LA 70810
Phone (225) 224-8690

5420 Plank Rd
Baton Rouge, LA 70805
Phone (225) 228-2452

2840 Florida St
Baton Rouge, LA 70802
Phone (225) 224-2402

8540 Siegen Ln
Ste A
Baton Rouge, LA 70810

409 Oak Plaza Blvd
Brusly, LA 70719
Phone (225) 877-3700

1706 SW Railroad Ave
Ste A
Hammond, LA 70403
Phone (985) 826-7782

17513 Old Jefferson Hwy
Prairieville, LA 70769
Phone (225) 673-7587

Organizations & group practices 3

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1902390222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD STE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD STE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MATTHEW",
        "middle_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "309629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.