Active NPI
Daniel S Matloff, MD
- Gastroenterology Physician
- Boston, MA
National Provider Identifier
1114963980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 40154
- Practice address
- 1153 Centre St
Suite 45
Boston, MA 02130-3446 - Phone
- (617) 522-9996
- Fax
- (617) 524-6599
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 40154 | MA | Primary |
Addresses
Primary practice location
1153 Centre St
Suite 45
Boston, MA 02130-3446
Mailing address
1153 Centre St
Suite 45
Boston, MA 02130-3446
Phone (617) 522-9996
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2070626 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gastroenterology Associates at Faulkner LLP | Gastroenterology | Current | Accepting new patients |
Locations
1153 Centre St
#45
Boston, MA 02130
Phone (617) 522-9996
1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000
1153 Centre St
Ste 45
Jamaica Plain, MA 02130
Phone (617) 522-9996
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 and National Provider Directory roles.
-
- Gastroenterology Physician
- Boston, MA
- NPI 1629189014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114963980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "SUITE 45",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-522-9996",
"fax_number": "617-524-6599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST",
"address_2": "SUITE 45",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-522-9996",
"fax_number": "617-524-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLOFF",
"first_name": "DANIEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MA",
"license": "40154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2070626",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.