Individual provider Active NPI

Matthew Ryan Johnson, ARNP, RN

  • Family Nurse Practitioner
  • Republic, WA
National Provider Identifier
1922735901
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61351549 Issued in WA
Practice address
10 Ros Cir
Republic, WA 99166-5002
Phone
(509) 775-3153
Fax
(509) 775-8929
NPI assigned
Aug 1, 2022
Last updated
Sep 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60972676 WA
Family Nurse Practitioner 363LF0000X AP61351549 WA Primary

Addresses

Primary practice location

10 Ros Cir
Republic, WA 99166-5002

Mailing address

53A Petes Retreat Rd
Republic, WA 99166-9541
Phone (425) 268-3587

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230321001177 WA Practitioner - Nurse Practitioner 2365816089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Ros Cir
Republic, WA 99166-5002
Phone (509) 775-3245

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
29.6 of 100Reported as group
Quality
32.46
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ferry County Public Hospital District No 1 CurrentSince Dec 9, 2022 Accepting new patients
Ferry County Public Hospital District No 1 CurrentSince Dec 9, 2022 Accepting new patients
Ferry County Public Hospital District No 1 CurrentSince Jan 6, 2025 Accepting new patients

Locations

10 Ros Cir
Republic, WA 99166
Phone (509) 775-3153

36 Klondike Rd
Republic, WA 99166
Phone (509) 775-3153

Interoperability endpoints

  • Direct secure messaging: mathew.johnson@ferrycohealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662249600000",
    "number": "1922735901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53A PETES RETREAT RD",
            "city": "REPUBLIC",
            "state": "WA",
            "postal_code": "991669541",
            "telephone_number": "425-268-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ROS CIR",
            "city": "REPUBLIC",
            "state": "WA",
            "postal_code": "991665002",
            "telephone_number": "509-775-3153",
            "fax_number": "509-775-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "ARNP, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60972676",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61351549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Republic, WA

Sources for this page

Verify at the official NPI Registry.