Active NPI
Matthew Matte
- General Practice Dentistry
- Albuquerque, NM
National Provider Identifier
1013350495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DD4201
- Practice address
- 1 Sagebrush St SW
Albuquerque, NM 87105-3942 - Phone
- (505) 925-4031
- Fax
- (505) 925-4030
- NPI assigned
- Apr 16, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DD4201 | NM | Primary |
Addresses
Primary practice location
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Mailing address
PO Box 640
Isleta, NM 87022-0640
Phone (505) 925-4031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD4201 | Other | NM | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170113001264 | TX | Order and Referring Only - Other (Physician) | 0648572669 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1013350495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "ISLETA",
"state": "NM",
"postal_code": "870220640",
"telephone_number": "505-925-4031",
"fax_number": "505-925-4030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SAGEBRUSH ST SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871053942",
"telephone_number": "505-925-4031",
"fax_number": "505-925-4030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTE",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-16",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "DD4201",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DD4201",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.