Active NPI
David Matousek, MD
- Family Medicine Physician
- Enid, OK
National Provider Identifier
1013006394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12725
- Practice address
- 330 S 5TH St Ste 302
Enid, OK 73701-5862 - Phone
- (580) 234-3320
- NPI assigned
- Oct 12, 2006
- Last updated
- Oct 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12725 | OK | Primary |
Addresses
Primary practice location
330 S 5TH St Ste 302
Enid, OK 73701-5862
Mailing address
PO Box 3494
Enid, OK 73702-3494
Phone (580) 234-3320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100089010A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12725 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enid Clinic Inc | Family Medicine | Current | Accepting new patients |
| Summit Medical Center | Past | Accepting new patients | |
| Uhs of Oklahoma Inc | Past | Accepting new patients |
Locations
3201 N Van Buren St
Ste 300
Enid, OK 73703
Phone (580) 233-5553
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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Family Medicine
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-
dba St Mary's Regional Medical Center
- Diagnostic Radiology Physician
- Enid, OK
- NPI 1982795696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1013006394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3494",
"city": "ENID",
"state": "OK",
"postal_code": "737023494",
"telephone_number": "580-234-3320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 S 5TH ST STE 302",
"city": "ENID",
"state": "OK",
"postal_code": "737015862",
"telephone_number": "580-234-3320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOUSEK",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "12725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100089010A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.