Daniel T Matulich, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G48662 Issued in CA

Practice address

1165 Montgomery Dr
Santa Rosa Memorial Hospital
Santa Rosa, CA 95405-4801

Phone

(707) 552-1573

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acute Medical Providers, Inc.

  • Emergency Medicine Physician
  • Saint Helena, CA
  • NPI 1942571146
  NPD (past)
• Chase Dennis Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Santa Rosa, CA
  • NPI 1033152350
  NPD (past)
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  NPD (past)
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1043254600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "address_2": "SANTA ROSA MEMORIAL HOSPITAL",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-552-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATULICH",
        "first_name": "DANIEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G48662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G486620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Andrew Matthews, AMFT
• Christopher Robert Matthies
• Susan Shepro Matthies, MFT
• Susanne Mattsson
• Drew Matulich Petzel, ASW
• Pamela Maur, M.D.
• Caitlin Michelle Maus
• Max-Ability Inc
• Maxim Healthcare Services, Inc.
• Kathryn M Maxwell, PH.D.

• Emergency Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.

Verify at the official NPI Registry.