Individual provider Active NPI

Allyson Nicole Matthesen, PA-C

  • Physician Assistant
  • Jefferson City, MO
National Provider Identifier
1972201036
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2023001731 Issued in MO
Practice address
1125 Madison St
Jefferson City, MO 65101-5227
Phone
(573) 632-5000
Fax
(573) 632-5876
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 2023001731 MO Primary

Addresses

Primary practice location

1125 Madison St
Jefferson City, MO 65101-5227

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other identifiers 1

IdentifierTypeStateIssuer
220129220MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230816003714 MO Practitioner - Physician Assistant 7719349182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-2100

1020 Hitt St
Columbia, MO 65212-0001

1100 Virginia Ave
Columbia, MO 65212-0001
Phone (573) 882-2667

Hospital & facility affiliations

  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023001731MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince Jan 8, 2024 Accepting new patients
Curators of the University of Missouri Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1432 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5560

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

Organizations & group practices 4

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 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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1972201036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-632-5000",
            "fax_number": "573-632-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHESEN",
        "first_name": "ALLYSON",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023001731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220129220",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "1125 Madison St",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651015227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.