NPIMap

Individual provider Active NPI

Eric V. a. Matlock, D.O.

  • Family Medicine Physician
  • Washington, MO
National Provider Identifier
1093788762
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2005011343 Issued in MO
Practice address
901 E 5TH St
Medical Staff Office
Washington, MO 63090-3127
Phone
(636) 239-8231
Fax
(636) 239-9890
NPI assigned
Feb 10, 2006
Last updated
Sep 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2005011343 MO Primary

Addresses

Primary practice location

901 E 5TH St
Medical Staff Office
Washington, MO 63090-3127

Mailing address

PO Box 502852
Saint Louis, MO 63150-2852
Phone (314) 364-4200

Other identifiers 2

IdentifierTypeStateIssuer
P00769834OtherMORAILROAD MEDICARE
1093788762MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050819000602 MO Practitioner - Family PracticePractitioner - Hospitalist 9234169194 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Generation Clinical Partners LLCGroup PAC ID 1557687803, 24 clinicians
Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians

Practice addresses (Care Compare)

1 Meramec Bluffs Dr
Ballwin, MO 63021-3309
Phone (314) 925-0903

575 Couch Ave
Kirkwood, MO 63122-5536
Phone (314) 909-6000

723 S Laclede Station Rd
Saint Louis, MO 63119-4911
Phone (314) 925-0903

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005011343MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Adult Hospitalists- Jefferson, LLC CurrentSince Jan 1, 2020 Accepting new patients
Pai Participant 1 LLC CurrentSince May 6, 2025 Accepting new patients
Generation Clinical Partners LLC CurrentSince Jun 1, 2025 Accepting new patients
Generation Clinical Partners Aco, LLC CurrentSince Sep 1, 2025 Accepting new patients
Generation Clinical Partners LLC CurrentSince Jun 1, 2025 Accepting new patients
Generation Clinical Partners Aco, LLC CurrentSince Sep 1, 2025 Accepting new patients
Mercy Clinic Adult Hospitalists - Washington, LLC CurrentSince Jul 1, 2009 Accepting new patients
Mercy Hospital Lincoln Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Mercy Clinic East Communities Family Medicine Past Accepting new patients

Locations

1 Meramec Bluffs Dr
Ballwin, MO 63021
Phone (636) 861-0600

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10426 Baur Blvd
Saint Louis, MO 63132
Phone (314) 632-6265

505 Couch Ave
Saint Louis, MO 63122
Phone (314) 822-9911

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 E 5th St
Ofc
Washington, MO 63090
Phone (636) 239-8231

Interoperability endpoints

  • Direct secure messaging: eric.matlock.1@9850.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9850/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 6

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1093788762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 502852",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631502852",
            "telephone_number": "314-364-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 5TH ST",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903127",
            "telephone_number": "636-239-8231",
            "fax_number": "636-239-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOCK",
        "first_name": "ERIC",
        "middle_name": "V. A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2005011343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00769834",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093788762",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.