Matthew Henry Ederle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

495 Hawley LN # 2
Stratford, CT 06614-1597

Phone

(203) 375-2861

NPI assigned

Jan 17, 2022

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

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Connecticut Vascular Center LLCGroup PAC ID 8527951532, 32 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.63 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mederle@vascularexperts.directbygreenway.com
• Direct secure messaging: matthew.ederle.1@32135.direct.athenahealth.com

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.

• Southern Connecticut Vascular Center, LLC

  • Vascular Surgery Physician
  • Stratford, CT
  • NPI 1033318175
  Medicare reassignment Care Compare group
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CT

  Medicare reassignment NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1992456362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 RESEARCH DR STE 105",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846228",
            "telephone_number": "844-482-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN # 2",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141597",
            "telephone_number": "203-375-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDERLE",
        "first_name": "MATTHEW",
        "middle_name": "HENRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin F Rabine PP LLC
• Emma Dzialo, DMD
• Maurice E Legare, COTA/L
• Maurita A. Eaton, PA-C
• Ebenezer Home Care LLC
• Edward C. Corsello D.C. L.L.C
• Efficient Aides Agency
• Barbara A Eiben, CSW
• Elephant on the Couch
• Cynthia Eliezer, LPC

• Physician Assistant in Stratford, CT
• Providers in Stratford, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.