Individual provider Active NPI

Matthew Faust

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1962254656
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A179659 Issued in IA
Practice address
146 W Dale St Ste 201
Waterloo, IA 50703-1901
Phone
(319) 226-9888
NPI assigned
Apr 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A179659 IA Primary

Addresses

Primary practice location

146 W Dale St Ste 201
Waterloo, IA 50703-1901

Mailing address

146 W Dale St Ste 201
Waterloo, IA 50703-1901
Phone (319) 226-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240722000825 IA Practitioner - Nurse Practitioner 8921544479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Allen Memorial Hospital CorporationGroup PAC ID 4284546045, 149 clinicians

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3913

Hospital & facility affiliations

  • Allen Hospital Hospital, Waterloo, IA, CCN 160110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation Nurse Practitioner CurrentSince Aug 12, 2024 Accepting new patients
Allen Memorial Hospital Corporation Current Accepting new patients

Locations

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

419 E Donald St
Waterloo, IA 50703
Phone (319) 888-7604

146 W Dale St
Ste 201
Waterloo, IA 50703
Phone (319) 234-4431

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1962254656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 W DALE ST STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-226-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 W DALE ST STE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031901",
            "telephone_number": "319-226-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUST",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A179659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.