Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bryan P Mathieson, NP

Individual provider Family Nurse Practitioner · NPI 1205022555

Bryan P Mathieson, NP is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2023, 3 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Idaho, Indiana, Michigan and Missouri and 3 more.

Years since qualifying
3
Licensed in
ID, IN, MI, MO, TN, VA
In the registry since
2007
Specialties on file
7
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

11141 Parkview Plaza Dr Ste 305
Fort Wayne, IN 46845-1715
Phone: (260) 266-8900
Fax: (260) 266-8935
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 999 N Curtis Rd Ste 415, Boise, ID 83706-1334 — (208) 302-2600
  • 1701 N Senate Blvd, Indianapolis, IN 46202-1239 — (317) 962-0582
  • 601 John St Ste M-325, Kalamazoo, MI 49007-5358 — (269) 341-7140
  • 410 N State Of Franklin Rd Ste 130, Johnson City, TN 37604-6972 — (423) 431-2477
  • 1818 N Meade St, Appleton, WI 54911-3454 — (920) 729-3100

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71002603A (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 0024192011 (VA)
Nurse Practitioner Taxonomy 363L00000X · Licence 78183 (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 26537 (TN)
Nurse Practitioner Taxonomy 363L00000X · Licence 8890 (WI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 4704427019 (MI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2015002005 (MO)

Record details

NPI number1205022555
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedSeptember 20, 2007
Last updated in NPPESDecember 17, 2025
Certification dateDecember 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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