Individual provider Active NPI

Matthew Mackowsky

  • Surgery Physician
  • Elizabeth, NJ
National Provider Identifier
1104276542
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA11200600 Issued in NJ
Practice address
225 Williamson St
Elizabeth, NJ 07202-3625
Phone
(908) 994-5738
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X MC-2472 ID
Surgical Critical Care Physician 2086S0102X 01092242A IN
Student in an Organized Health Care Education/Training Program 390200000X NJ
Surgery Physician 208600000X 25MA11200600 NJ Primary
Surgery Physician 208600000X 92472 GA

Addresses

Primary practice location

225 Williamson St
Elizabeth, NJ 07202-3625

Mailing address

379 Campus Dr
Somerset, NJ 08873-1161
Phone (732) 937-8939

Other practice location 1

300 2nd Ave
Long Branch, NJ 07740-6303
Phone (732) 923-6769

Other practice location 2

999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone (208) 302-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA, NJ, IN4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20221116003293 GA Practitioner - General Surgery 2769850031 Reassigns benefits to 2 organizations
I20231114001417 PA Practitioner - General Surgery 2769850031 Reassigns benefits to 1 organization
I20231130000348 NJ Practitioner - General Surgery 2769850031 Reassigns benefits to 3 organizations
I20240315002406 IN Practitioner - General Surgery 2769850031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Drexel University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92472GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Mar 11, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Mar 11, 2024 Accepting new patients
St Josephs Medical Group PC CurrentSince Oct 28, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Oct 21, 2023 Accepting new patients
Emory Medical Care Foundation Inc Surgery CurrentSince Oct 9, 2025 Accepting new patients
Barnabas Health Medical Group PC Surgery CurrentSince Oct 17, 2024 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 17, 2024 Accepting new patients
Susquehanna Physician Services CurrentSince Oct 18, 2023 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Oct 17, 2023 Accepting new patients
Susquehanna Physician Services Surgery CurrentSince Oct 18, 2023 Accepting new patients
Rwjbh Primary Care Services PastSince Jan 26, 2025 Accepting new patients
Saint Alphonsus Specialty Services Inc Surgery Past Accepting new patients
Barnabas Health Medical Group, PC PastSince Jan 26, 2025 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients
St. Joseph'S Healthcare, Inc. Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

7900 W Jefferson Blvd
Ste 306
Fort Wayne, IN 46804
Phone (260) 458-3610

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

225 Minnisink Rd
Totowa, NJ 07512
Phone (862) 657-3000

220 Hamburg Tpke
Ste 16
Wayne, NJ 07470
Phone (973) 389-6090

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

740 High St
Ste 1003
Williamsport, PA 17701
Phone (570) 321-3160

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: matthew.a.mackowsky@upmcdirect.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1104276542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 CAMPUS DR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731161",
            "telephone_number": "732-937-8939",
            "fax_number": "732-418-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023625",
            "telephone_number": "908-994-5738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-923-6769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N Curtis Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061334",
            "country_code": "US",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKOWSKY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "MC-2472",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IN",
            "license": "01092242A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA11200600",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "92472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.