MATTHEW JAMES DOLAN (NPI# 1215423504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215423504 |
| Entity Type | Individual |
| Full Name | MATTHEW JAMES DOLAN |
| Credential | PA-C |
| Practice Address |
1726 Shawano Ave Green Bay WI 54303 |
| Mailing Address |
111 E Wisconsin Ave Ste 2000 Milwaukee WI 53202-4809 |
| Practice Telephone | 4142906720 |
| Practice Fax Number | 4142906755 |
| Mailing Telephone | 4142906720 |
| Mailing Fax Number | 4142906755 |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-08-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4493-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 835 S Van Buren St, Green Bay, WI 543013526 | 4142906720 | 4142906755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154076 | Matthew Thomas Dolan | Behavioral Analyst | 26300 Chester Ct, Tehachapi, CA 93561-7476 | 2019-10-01 |
| 1821436494 | Matthew Dolan | Emergency Medicine | 20 York St # T-209, Yale-new Haven Hospital, New Haven, CT 06510-3220 | 2013-06-05 |
| 1770834657 | Matthew Charles Dolan | Physician Assistant | 71 Haynes St, Manchester, CT 06040-4131 | 2012-10-02 |
| 1558386201 | Matthew J. Dolan | Internal Medicine | 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234-4504 | 2006-07-13 |
| Street Address |
1726 SHAWANO AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356324990 | Thomas M. Farley | Anesthesiology | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2005-11-29 |
| 1265048805 | Hillary Ann Bashaw | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2020-09-18 |
| 1043828387 | St Mary's Hospital Medical Center of Green Bay Inc.-hospital Sisters | Clinical Medical Laboratory | 1726 Shawano Ave, Green Bay, WI 54303-3282 | 2020-07-22 |
| 1750930079 | Jenna Mae Spude | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2019-09-09 |
| 1013430073 | Whitney Jo Brusich | Physician Assistant | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2017-07-21 |
| 1720510043 | Christina R Mestelle | Physical Therapist | 1726 Shawano Ave, Green Bay, WI 54303 | 2017-03-28 |
| 1407231178 | Ahmed Farouk Mohammed | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-07-23 |
| 1184004236 | St. Vincent Hospital-hospital Sisters-third Order of St. Francis | Internal Medicine | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-06-04 |
| 1629468343 | Lynn Wilson | Nurse Practitioner | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2015-02-02 |
| 1063821502 | Kayla Rene' Guns | Registered Nurse | 1726 Shawano Ave, Green Bay, WI 54303-3216 | 2014-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700253101 | Mathias Dahnert | Physician Assistant | 945 S Irwin Ave, Green Bay, WI 54301-3309 | 2015-09-01 |
| 1770992067 | Sheila M Teddy | Physician Assistant | 2595 Development Dr Ste 150, Green Bay, WI 54311-4288 | 2014-08-12 |
| 1245652718 | Bailey Bauer | Physician Assistant | 2753 Mayline Dr, Green Bay, WI 54311-9646 | 2014-01-17 |
| 1588949333 | Carissa Ann Coorough | Physician Assistant | 720 S Van Buren St Ste 301, Green Bay, WI 54301-3534 | 2011-10-12 |
| 1093942047 | Taresa B Fassbender | Physician Assistant | 3263 Eaton Rd Ste 1, Green Bay, WI 54311-6830 | 2009-06-17 |
| 1265628507 | Colleen M Van Egeren | Physician Assistant | 715 Superior Rd, Suite 120, Green Bay, WI 54311-7594 | 2007-09-20 |
| 1427079516 | Dermatology Clinic S.c. | Physician Assistant | 715 Superior Rd Ste 120, Green Bay, WI 54311-7595 | 2006-07-22 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1841233186 | Randall R Southards | Physician Assistant | 2845 Greenbrier Rd Ste 320, Green Bay, WI 54311-6519 | 2006-06-14 |
| 1285684662 | Elaine M Smith | Physician Assistant | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2006-05-10 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.