Individual provider Active NPI

Matthew Maia

  • Military Health Care Provider
  • Pascagoula, MS
National Provider Identifier
1164110995
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
010128359 Issued in VA
Practice address
1000 Access Rd # 4
Pascagoula, MS 39567-4485
Phone
(228) 935-3252
NPI assigned
Apr 28, 2023
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 010128359 VA Primary

Addresses

Primary practice location

1000 Access Rd # 4
Pascagoula, MS 39567-4485

Mailing address

14801 Lemoyne Blvd Apt 359
Biloxi, MS 39532-7035
Phone (228) 935-3252

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

State licenses

LicenseStateTypeSpecialty
010128359VAMDMilitary Health Care Provider

Interoperability endpoints

  • Direct secure messaging: mmaia33185@direct.utmsa.com

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1164110995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14801 LEMOYNE BLVD APT 359",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395327035",
            "telephone_number": "228-935-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ACCESS RD # 4",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395674485",
            "telephone_number": "228-935-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIA",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "010128359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.