NPIMap

Individual provider Active NPI

Charles Christian Matouk, M.D.

  • Neurological Surgery Physician
  • New Haven, CT
National Provider Identifier
1053696187
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
50158 Issued in CT
Practice address
800 Howard Ave
Lower Level, Neuroscience Center
New Haven, CT 06519-1369
Phone
(203) 737-2096
Fax
(203) 785-2044
NPI assigned
Oct 20, 2011
Last updated
Sep 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 50158 CT Primary

Addresses

Primary practice location

800 Howard Ave
Lower Level, Neuroscience Center
New Haven, CT 06519-1369

Mailing address

PO Box 208082, 333 Cedar Street, TMP 402
Yale University, Department of Neurosurgery
New Haven, CT 06510-3206
Phone (203) 737-2096

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111104000412 CT Practitioner - NeurosurgeryPractitioner - Interventional Radiology 9931372075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Interventional Radiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Neurological Surgery CurrentSince Oct 2, 2011 Accepting new patients
Yale University CurrentSince Oct 2, 2011 Accepting new patients

Locations

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

800 Howard Ave
Lowr
New Haven, CT 06519
Phone (203) 785-4085

Interoperability endpoints

  • Direct secure messaging: cmatouk64452@direct.ynhh.org

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1053696187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208082, 333 CEDAR STREET, TMP 402",
            "address_2": "YALE UNIVERSITY, DEPARTMENT OF NEUROSURGERY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-737-2096",
            "fax_number": "203-785-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE",
            "address_2": "LOWER LEVEL, NEUROSCIENCE CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-737-2096",
            "fax_number": "203-785-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOUK",
        "first_name": "CHARLES",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CT",
            "license": "50158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.