Individual provider Active NPI

Matthew Tynes Coleman, PA-C

  • Medical Physician Assistant
  • Haughton, LA
National Provider Identifier
1972685683
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.A10348 Issued in LA
Practice address
3418 Heatherbrook Dr
Haughton, LA 71037-8513
Phone
(318) 381-3696
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.A10348 LA Primary

Addresses

Primary practice location

3418 Heatherbrook Dr
Haughton, LA 71037-8513

Mailing address

3418 Heatherbrook Dr
Haughton, LA 71037-8513
Phone (318) 381-3696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20050721000042 LA Practitioner - Physician Assistant 2668433798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bossier Family Medicine, LLCGroup PAC ID 1850318122, 21 clinicians

Practice addresses (Care Compare)

2539 Viking Dr
Bossier City, LA 71111-2165

Hospital & facility affiliations

  • Professional HH SVC of Minden Home health agency, Minden, LA, CCN 197026
  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • North Caddo Medical Center Hospital, Vivian, LA, CCN 191304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.A10348LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bossier Family Medicine, LLC CurrentSince Sep 11, 2022 Accepting new patients
Gastrointestinal Specialists, a.M.C. PastSince Jan 1, 1990 Accepting new patients

Locations

2539 Viking Dr
Ste 100
Bossier City, LA 71111
Phone (318) 747-8100

5390 Barksdale Blvd
Ste 100
Bossier City, LA 71112
Phone (318) 747-8100

2539 Viking Dr
Ste 101
Bossier City, LA 71111
Phone (318) 747-8100

160 Stone Creek Rd
Ste A
Stonewall, LA 71078
Phone (318) 925-3339

Organizations & group practices 3

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 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1972685683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 HEATHERBROOK DR",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378513",
            "telephone_number": "318-381-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 HEATHERBROOK DR",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378513",
            "telephone_number": "318-381-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MATTHEW",
        "middle_name": "TYNES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.A10348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haughton, LA

Sources for this page

Verify at the official NPI Registry.