Individual provider Active NPI

Matthew Killips, PHARM.D

  • Pharmacist
  • Geneva, NY
National Provider Identifier
1164063228
Registry record updated Jan 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064958 Issued in NY
Practice address
431 Hamilton St
Geneva, NY 14456-3001
Phone
(315) 781-9080
NPI assigned
Sep 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064958 NY Primary

Addresses

Primary practice location

431 Hamilton St
Geneva, NY 14456-3001

Mailing address

431 Hamilton St
Geneva, NY 14456-3001
Phone (315) 781-9080

Other practice location 1

173 Market St
Potsdam, NY 13676-1221
Phone (315) 265-6192

Other practice location 2

3035 East Ave
Central Square, NY 13036-2611
Phone (315) 688-7363

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
064958NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 6, 2022 Accepting new patients
Walgreen Co CurrentSince Mar 13, 2022 Accepting new patients
Walgreen Co PastSince Oct 1, 2019 Accepting new patients

Locations

431 Hamilton St
Geneva, NY 14456
Phone (315) 781-9080

173 Market St
Potsdam, NY 13676
Phone (315) 265-2603

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.

NPI Registry JSON

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674259200000",
    "number": "1164063228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 HAMILTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144563001",
            "telephone_number": "315-781-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 HAMILTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144563001",
            "telephone_number": "315-781-9080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Market St",
            "address_purpose": "LOCATION",
            "city": "Potsdam",
            "state": "NY",
            "postal_code": "136761221",
            "country_code": "US",
            "telephone_number": "315-265-6192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3035 East Ave",
            "address_purpose": "LOCATION",
            "city": "Central Square",
            "state": "NY",
            "postal_code": "130362611",
            "country_code": "US",
            "telephone_number": "315-688-7363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLIPS",
        "first_name": "MATTHEW",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-01-21",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.