Individual provider Active NPI

Matthew D Kline, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Bronx, NY
National Provider Identifier
1043623762
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
310548 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 992-7669
NPI assigned
Jun 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 66034 AZ
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 310548 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

1276 Fulton Ave
Bronx, NY 10456-3402
Phone (718) 992-7669

Other practice location 1

14 Woodside Dr
Woodbridge, CT 06525-2037
Phone (203) 915-3637

Other practice location 2

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 309-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521000373 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 9234401605 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2023 Accepting new patients
Bronxcare Health System CurrentSince May 14, 2021 Accepting new patients
Bronxcare Health System Pediatrics CurrentSince May 14, 2021 Accepting new patients
New York University Pediatrics CurrentSince Jul 1, 2023 Accepting new patients
Scripps Health Current Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Bronx, NY 10456
Phone (718) 518-5000

Interoperability endpoints

  • Direct secure messaging: mkline3554981@nychhc.direct-ci.com
  • Direct secure messaging: mkline385558@scrippshlth.medalliesdirect.net
  • Direct secure messaging: mkline556340@nyumc.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1043623762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Woodside Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "CT",
            "postal_code": "065252037",
            "country_code": "US",
            "telephone_number": "203-915-3637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-309-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLINE",
        "first_name": "MATTHEW",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "66034",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "310548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.