Matthew Joseph Granner
Individual provider Active NPI Physician Assistant · Dyersburg, TN
NPI 1992345045 · NPPES record last updated Aug 10, 2023
Key facts
- NPI
- 1992345045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 2035 Saint John Ave
Dyersburg, TN 38024-2247 - Phone
- (316) 619-8257
- NPI assigned
- Jan 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Tennessee Bone and Joint Clinic PC
Practice addresses (Care Compare)
2035 Saint John Ave
Suite 1
Dyersburg, TN 38024-2209
Phone (731) 661-9825
50 Capital Ave
Jackson, TN 38305-5507
Phone (731) 661-9825
Hospital & facility affiliations
- Dyersburg Regional Medical Center
- Lauderdale Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 73.85
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200812000731 | TN | Practitioner - Physician Assistant | 3274959960 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Interoperability endpoints
- matthew.granner.1@3533.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
2035 Saint John Ave
Dyersburg, TN 38024-2247
Mailing address
120 Gene Adams Rd
Martin, TN 38237-8146
Phone (731) 514-3708
Other providers in Dyersburg, TN
- Jill Christine Gatlin
- Geriatric Essentials, PC
- Harry Robert Gilley
- Grace Family Practice Clinic, P.C.
- Ashten Granner
- Daniel P Green
- Wendy Hope Greene
- Whitney Greene
- Barry Anthony Greenlee
- Gracie M Griffith
All providers in Dyersburg, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.