Sportsmedicine Outreach Specialist
NPI 1053898833ActiveOrganization· Physician Assistant, Surgical· Gilbert, AZ
Physician Assistant, Surgical in Gilbert, Arizona, registered in NPPES in July 2018. The authorized official on file is Matthew Dean Overlin, PA-C, Physician Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053898833 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 24, 2018 |
| Last updated in NPPES | Mar 17, 2026 |
| Certified by provider | Mar 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | 3233 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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