Travis Matsumoto, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA156342

Practice address

920 Country Club Rd Ste 200a
Eugene, OR 97401-6086

Phone

(541) 242-4220

Fax

(541) 686-6021

NPI assigned

Feb 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498
  NPD (past)

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1972875334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 COUNTRY CLUB RD STE 200A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016086",
            "telephone_number": "541-242-4220",
            "fax_number": "541-686-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 COUNTRY CLUB RD STE 200A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016086",
            "telephone_number": "541-242-4220",
            "fax_number": "541-686-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "TRAVIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-01",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA156342",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "PA156342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA156342",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Yvonne Mathis
• Matlock Dental LLC
• Krysta Matsen
• Norman Matson, CRNA
• Robyn Yuki Matsumoto, CHW, CRM
• Matt W Anderson DDS PC
• Brooke Kathleen Matteo, AUD
• Michael Matteo, PT
• Sara Matteri
• Jordan Marie Mattern, MD

• Medical Physician Assistant in Eugene, OR
• Providers in Eugene, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.