Individual provider Active NPI

Matthew Cook, DO

  • Family Medicine Physician
  • San Tan Valley, AZ
National Provider Identifier
1114451986
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
008623 Issued in AZ
Practice address
37100 N Gantzel Rd Ste 201
San Tan Valley, AZ 85140-7352
Phone
(480) 394-4469
Fax
(480) 394-4520
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 008623 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X BP10060975 TX

Addresses

Primary practice location

37100 N Gantzel Rd Ste 201
San Tan Valley, AZ 85140-7352

Mailing address

37100 N Gantzel Rd Ste 201
San Tan Valley, AZ 85140-7352
Phone (480) 394-4469

Other practice location 1

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.28 of 100Reported as group
Quality
83.84
Promoting interoperability
100
Improvement activities
40
Cost
73.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008623AZMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1114451986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 201",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407352",
            "telephone_number": "480-394-4469",
            "fax_number": "480-394-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 201",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407352",
            "telephone_number": "480-394-4469",
            "fax_number": "480-394-4520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11937 US Highway 271",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757083154",
            "country_code": "US",
            "telephone_number": "903-877-7777",
            "fax_number": "903-877-7285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "008623",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10060975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.