Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ETHAN JAMES MATTHEW MD
NPI 1336889559
Dermatology in Casper, WY

Active since March 29, 2022PECOS Enrolled
6631 E 2ND ST STE 100, CASPER, WY 82609(307) 243-1155(307) 243-1199 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ethan James Matthew Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN JAMES MATTHEW MD (NPI 1336889559) is an individual dermatology provider in Casper, Wyoming, licensed in Wyoming (19102A) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1336889559
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameETHAN JAMES MATTHEWCredential: MD
Location Address6631 E 2ND ST STE 100Casper, WY 82609-4355
Mailing Address801 York StManitowoc, WI 54220-4630 · (920) 663-9008 · Fax (920) 684-1439
Fax(307) 243-1199
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 29, 2022
Last NPPES UpdateJuly 2, 2026
NPPES CertifiedJuly 2, 2026
NPI 1336889559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in WY · 19102A
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
6631 E 2ND ST STE 100, Casper, WY 82609

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ethan James Matthew Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719442938
PECOS Enrollment IDI20260717004119
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 82609 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.12 typical visit price
range $56.42 – $170.72
Typical copayment $21.78 (range $14.10 – $42.68)
Most-billed visit code 99203
Established Patient
$70.32 typical visit price
range $18.19 – $139.32
Typical copayment $17.58 (range $4.54 – $34.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology
6631 E 2ND ST STE 100
CASPER, WY 82609

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Matthew's NPI number?

The NPI number for Ethan Matthew is 1336889559. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Where is Ethan Matthew located?

Ethan Matthew practices at 6631 E 2nd St Ste 100, Casper, WY 82609. The listed phone number is (307) 243-1155.

What is Ethan Matthew's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Ethan Matthew enrolled in Medicare?

Yes. Ethan Matthew is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Matthew was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.