Individual provider Active NPI

Gary L. Matson Jr., D.O.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1154344695
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A6263 Issued in CA
Practice address
4501 Mission Bay Dr
Suite 3E
San Diego, CA 92109-4923
Phone
(858) 270-4343
Fax
(858) 272-1731
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A6263 CA Primary

Addresses

Primary practice location

4501 Mission Bay Dr
Suite 3E
San Diego, CA 92109-4923

Mailing address

4501 Mission Bay Dr
Suite 3E
San Diego, CA 92109-4923
Phone (858) 270-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100429001150 CA Practitioner - Family Practice 4486781036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4501 Mission Bay Dr
Suite 3E
San Diego, CA 92109-4926
Phone (858) 270-4343

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gary L Matson DO Inc Family Medicine CurrentSince Mar 15, 2001 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients

Locations

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gmatson81306@scrippshlth.medalliesdirect.net

Organizations & group practices 3

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 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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154344695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 MISSION BAY DR",
            "address_2": "SUITE 3E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094923",
            "telephone_number": "858-270-4343",
            "fax_number": "858-272-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MISSION BAY DR",
            "address_2": "SUITE 3E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921094923",
            "telephone_number": "858-270-4343",
            "fax_number": "858-272-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.