MR. MATTHEW J MARTIN (NPI# 1871516047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871516047 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW J MARTIN |
| Credential | PA-C |
| Practice Address |
17030 Lakeside Hills Plz Suite 200 Omaha NE 68130-2396 |
| Practice Telephone | 4023998550 |
| Practice Fax Number | 4023998455 |
| Mailing Telephone | 4023998550 |
| Mailing Fax Number | 4023998455 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2087 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085002515 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
85002515 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1548646250 | Matthew Martin | Specialist | 5497 Northern Dancer, Springdale, AR 72762-8337 | 2015-08-04 |
| 1942602230 | Matthew Gordon Martin | Physical Therapist | 8400 Holcolm Bridge Road, Suite 480, Alpharetta, GA 30022 | 2014-09-18 |
| 1982044343 | Matthew Brian Martin | Dentist | 415 S Pendleton St, Easley, SC 29640-3072 | 2013-07-01 |
| 1336432293 | Matthew Martin | Counselor | 20 Wacker Drive, 1442, Chicago, IL 60606 | 2011-05-25 |
| 1902080823 | Matthew A. Martin | Pathology | 2311 Wilderness Hl, San Antonio, TX 78231-1838 | 2007-12-27 |
| 1780704932 | Matthew W Martin | Anesthesiology | 4511 Park Forest Drive, Suite 210, Traverse City, MI 49684 | 2007-03-30 |
| 1033235569 | Matthew John Martin | Dentist | 1927 Broad Ripple Avenue, Indianapolis, IN 46220 | 2007-03-22 |
| 1386725802 | Matthew Robert Martin | Physical Therapist | 123 West Academy Street, Hughesville, PA 17737 | 2006-10-18 |
| 1215028709 | Matthew J. Martin | Physical Therapist | Usameddac Wuerzburg Physical Therapy Clinic, Unit 26610, Apo, AE 09244 | 2006-09-27 |
| Street Address |
17030 LAKESIDE HILLS PLZ SUITE 200 |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-2396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205834173 | Mendy Marie Peterson | Physician Assistant | 17030 Lakeside Hills Plz, Suite 102, Omaha, NE 68130-2396 | 2005-07-13 |
| 1710426549 | Jessica Cannon | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2017-02-13 |
| 1881132256 | Kakish Md Senior Care, PC | Hospitalist | 17030 Lakeside Hills Plz, Suite 130, Omaha, NE 68130-2396 | 2017-02-06 |
| 1205373776 | Hayley Christensen | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130 | 2017-01-23 |
| 1114460904 | Ellen A Thomsen | Dietitian, Registered | 17030 Lakeside Hills Plz, Omaha, NE 68130-2396 | 2016-11-28 |
| 1811238728 | Sarah P Hennings | Physician Assistant | 17030 Lakeside Hills Plz, Ste 202, Omaha, NE 68130-2396 | 2013-03-04 |
| 1245472786 | Jaime L Dobson | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2009-03-30 |
| 1699917492 | Nicholas Wegner | Orthopaedic Surgery | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2009-03-25 |
| 1619116183 | Infectious Disease & Epidemiology Associates PC | Internal Medicine | 17030 Lakeside Hills Plz, Suite 202, Omaha, NE 68130-2396 | 2009-02-06 |
| 1386889442 | Gross, Iwersen, Kratochvil & Klein Md PC | Orthopaedic Surgery | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2008-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518031194 | Peter W Hunt | Physician Assistant | Children's Hospital - Cardiothoracic Surgery, 8200 Dodge Street, Omaha, NE 68114-4113 | 2006-11-17 |
| 1457354789 | Jennifer Chavez | Physician Assistant | 9850 Nicholas St, Ste 250, Omaha, NE 68114-2186 | 2005-05-31 |
| 1184224537 | Ashton N Groves | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2020-10-27 |
| 1336763879 | Makenzie Polacek | Physician Assistant | 13616 California St Ste 100, Omaha, NE 68154-5336 | 2020-06-01 |
| 1508499054 | Samantha Schroeder | Physician Assistant | 13616 California St Ste 100, Omaha, NE 68154-5336 | 2020-02-12 |
| 1487121034 | Kelli D Welch | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2018-10-31 |
| 1114405040 | Victoria M Alai | Physician Assistant | 8200 Dodge St, Omaha, NE 68114-4113 | 2018-08-02 |
| 1891202131 | Kossi Mawouli Zotoglo | Physician Assistant | 4101 Woolworth Ave, Omaha, NE 68105-1850 | 2018-01-09 |
| 1710426549 | Jessica Cannon | Physician Assistant | 17030 Lakeside Hills Plz, Suite 200, Omaha, NE 68130-2396 | 2017-02-13 |
| 1952649162 | Samantha J. Korth | Physician Assistant | 16909 Lakeside Hills Ct, #208, Omaha, NE 68130-4664 | 2013-01-22 |
| Find all providers in OMAHA | ||||
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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.