Matthew A Kahanic, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

TA1681 Issued in AL

Practice address

201 Governors Drive 1St Floor
Huntsville, AL 35801-5171

Phone

(256) 533-1600

Fax

(256) 539-0856

NPI assigned

Feb 4, 2009

Last updated

Jul 26, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1952549560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DRIVE 1ST FLOOR",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015171",
            "telephone_number": "256-533-1600",
            "fax_number": "256-539-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHANIC",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "TA1681",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "TA1681",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "TA1681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Surgical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.