Individual provider Active NPI

Matthew Ryan Tommack, D.O.

  • Diagnostic Radiology Physician
  • Eugene, OR
National Provider Identifier
1063645570
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101018452 Issued in OR
Practice address
600 Country Club Rd
Eugene, OR 97401-2240
Phone
(541) 242-4162
Fax
(541) 345-2358
NPI assigned
Aug 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101018452 OR Primary

Addresses

Primary practice location

600 Country Club Rd
Eugene, OR 97401-2240

Mailing address

PO Box 1648
Eugene, OR 97440-1648
Phone (541) 242-4384

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (208) 283-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150622000334 OR Practitioner - Diagnostic Radiology 8224349048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oregon Healthcare Resources LLCGroup PAC ID 4486835477, 160 clinicians

Practice addresses (Care Compare)

600 Country Club Rd
Eugene, OR 97401-2240
Phone (541) 345-0600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018452ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Healthcare Resources, LLC CurrentSince Sep 10, 2017 Accepting new patients

Locations

600 Country Club Rd
Eugene, OR 97401
Phone (541) 242-4172

2000 N 19th St
Springfield, OR 97477
Phone (541) 284-1694

Interoperability endpoints

  • Direct secure messaging: mtommack42184@westdirect.optum.com

Organizations & group practices 1

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1063645570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1648",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974401648",
            "telephone_number": "541-242-4384",
            "fax_number": "541-463-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COUNTRY CLUB RD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012240",
            "telephone_number": "541-242-4162",
            "fax_number": "541-345-2358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "208-283-1949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMMACK",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-31",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "5101018452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.