NPIMap

Individual provider Active NPI

Eran Matalon, M.D.

  • Internal Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1073656815
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G66269 Issued in CA
Practice address
500 Doyle Park Dr
Suite 304
Santa Rosa, CA 95405-4558
Phone
(707) 545-1700
Fax
(707) 579-1958
NPI assigned
Feb 14, 2007
Last updated
Feb 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G66269 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr
Suite 304
Santa Rosa, CA 95405-4558

Mailing address

500 Doyle Park Dr
Suite 304
Santa Rosa, CA 95405-4558
Phone (707) 545-1700

Other identifiers 1

IdentifierTypeStateIssuer
00G662690MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100312000120 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 2860392099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Rush Medical College of Rush University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1162 Montgomery Dr
Santa Rosa, CA 95405-4802

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Oct 14, 2013 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Oct 14, 2013 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Hilborn Care Inc PastSince Jan 1, 2002 Accepting new patients
Queen of the Valley Medical Association Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Locations

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

500 Doyle Park Dr
Ste 304
Santa Rosa, CA 95405
Phone (707) 545-1700

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arbol Residences of Santa RosaSanta Rosa, CA, CCN 555836 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 15, 2024
Apr 22, 2025
Creekside Rehabilitation & Behavioral HealthSanta Rosa, CA, CCN 056090 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2002
Jan 1, 2002

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Hilborn Care Inc

    dba Creekside Rehabilitation and Behavioral Health

    • Skilled Nursing Facility
    • Santa Rosa, CA
    • NPI 1326734625

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • LCS Santa Rosa LLC
    • Skilled Nursing Facility
    • Santa Rosa, CA
    • NPI 1184246639

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 8

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 9

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1073656815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 304",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-545-1700",
            "fax_number": "707-579-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "SUITE 304",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-545-1700",
            "fax_number": "707-579-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATALON",
        "first_name": "ERAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G66269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G662690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.