NPIMap

Individual provider Active NPI

Matthew Lee Rontal, M.D.

  • Otolaryngology Physician
  • Royal Oak, MI
National Provider Identifier
1114946704
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301075607 Issued in MI
Practice address
30701 Woodward Ave Ste 200
Royal Oak, MI 48073-0990
Phone
(248) 737-4030
Fax
(248) 307-7873
NPI assigned
Jul 18, 2006
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301075607 MI
Otolaryngology Physician 207Y00000X 4301075607 MI Primary

Addresses

Primary practice location

30701 Woodward Ave Ste 200
Royal Oak, MI 48073-0990

Mailing address

30701 Woodward Ave Ste 200
Royal Oak, MI 48073-0990
Phone (248) 737-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060921000423 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 8820093024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Michigan Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakland Medical Services PCGroup PAC ID 5597793265, 2 clinicians

Practice addresses (Care Compare)

30701 Woodward Ave
Suite 200
Royal Oak, MI 48073-0990
Phone (248) 737-4030

3555 W 13 Mile Rd
Suite 200
Royal Oak, MI 48073-6710
Phone (248) 737-4030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Medical Services, P.C. Otolaryngology CurrentSince Feb 1, 2010 Accepting new patients

Locations

30701 Woodward Ave
Ste 200
Royal Oak, MI 48073
Phone (248) 288-9333

3555 W 13 Mile Rd
Ste 200
Royal Oak, MI 48073
Phone (248) 254-8204

Interoperability endpoints

  • Direct secure messaging: matthew.rontal.1@17789.direct.athenahealth.com

Organizations & group practices 1

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 11

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1114946704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30701 WOODWARD AVE STE 200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730990",
            "telephone_number": "248-737-4030",
            "fax_number": "248-307-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30701 WOODWARD AVE STE 200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730990",
            "telephone_number": "248-737-4030",
            "fax_number": "248-307-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONTAL",
        "first_name": "MATTHEW",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301075607",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301075607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.