Individual provider Active NPI

Matthew Enriquez, MD

  • Infectious Disease Physician
  • Minneapolis, MN
National Provider Identifier
1104236405
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
68015 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 672-7422
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 036142884 IL
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X 68015 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0600

Other practice location 1

833 Chestnut St
Suite 220
Philadelphia, PA 19107-4414
Phone (215) 955-8465

Other practice location 2

5841 S Maryland Ave # Mc5065
Chicago, IL 60637-1447
Phone (773) 702-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190812000925 IL Practitioner - Infectious Disease 7810114360 Reassigns benefits to 1 organization
I20201005001983 MN Practitioner - Infectious Disease 7810114360 Reassigns benefits to 3 organizations
I20260617000473 PA Practitioner - Infectious Disease 7810114360

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036142884ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Nov 20, 2020 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 17, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Nov 20, 2020 Accepting new patients
University of Minnesota Pediatric Dental Clinic CurrentSince Nov 20, 2020 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Nov 20, 2020 Accepting new patients
Fairview Express Care CurrentSince Nov 20, 2020 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 17, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Nov 20, 2020 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 200
Minneapolis, MN 55414
Phone (612) 730-1345

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

Interoperability endpoints

  • Direct secure messaging: menriquez598932@fairview.direct-ci.com
  • Direct secure messaging: menriquezmd152002@uchospital.direct-ci.com

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1104236405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142924",
            "telephone_number": "612-884-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-672-7422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Chestnut St",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074414",
            "country_code": "US",
            "telephone_number": "215-955-8465",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5841 S Maryland Ave # Mc5065",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371447",
            "country_code": "US",
            "telephone_number": "773-702-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036142884",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "68015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.