Matthew Aaron Widdison, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-17421 Issued in ID

Practice address

2100 Alan St
Idaho Falls, ID 83404-5801

Phone

(208) 528-7655

NPI assigned

Apr 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Washington School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Council of Idaho, Inc.Group PAC ID 6204877467, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.widdison@hca3.eclinicaldirectplus.com
• Direct secure messaging: matthew.widdison.1@16437.direct.athenahealth.com

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.

• Community Council of Idaho, Inc

  • Federally Qualified Health Center (FQHC)
  • Idaho Falls, ID
  • NPI 1710925250

  Family Medicine

  Medicare reassignment Care Compare group NPD
• North Canyon Medical Center Inc.

  dba North Canyon Medical Center

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment NPD
• Community Council of Idaho, Inc.

  dba Community Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Blackfoot, ID
  • NPI 1356416861

  Family Medicine

  NPD
• Community Council of Idaho, Inc.

  dba Rigby Community Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Rigby, ID
  • NPI 1710664834

  Family Medicine

  NPD
• North Canyon Medical Center, Inc.

  dba North Canyon Imaging Center Twin Falls

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1932789260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 ALAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045801",
            "telephone_number": "208-528-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 ALAN ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045801",
            "telephone_number": "208-528-7655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4002 E 397 N",
            "address_purpose": "LOCATION",
            "city": "Rigby",
            "state": "ID",
            "postal_code": "834425456",
            "country_code": "US",
            "telephone_number": "208-228-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDDISON",
        "first_name": "MATTHEW",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-17421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Whitlow, FNP
• Derek Richard Whitmill
• Kaylene Marie Whitten, LMSW
• Whitney Anne Whittle
• Whole Hearted Birth, LLC
• Hiram Benjamin Wigant, MS, RD
• Wight Chiropractic, PA (Legacy Health Partners)
• Gary Christopher Wight, D.C.
• Joseph Monte Wight, DPT
• Brigham Wilcox, PHARMD

• Family Medicine Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.