Matthew A Wilson, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA714 Issued in ME

Practice address

264 Pleasant St
Concord, NH 03301-2551

Phone

(603) 224-3368

Fax

(603) 224-7815

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

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.

• Maine Coast Regional Health Facilities

  • Internal Medicine Physician
  • Ellsworth, ME
  • NPI 1598152035
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1972547552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 PLEASANT STREET",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-224-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-224-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297110099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099683",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad Wilson
• Deborah Wilson
• Elisha Wilson
• Kaitlin Wilson, MS, LCMHC
• Lauren Christine Wilson, CNM
• Meghan Shea Wilson, DPT
• Peter H Wilson, M.D.
• Roger Wilson
• Scot Wilson, MS, LCMHC
• Amanda L Winch, OTL

• Surgical Physician Assistant in Concord, NH
• Providers in Concord, NH by specialty
• Surgical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.