NPIMap

Individual provider Active NPI

Matthew Alan Gill, MD

  • Internal Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1164469821
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301087057 Issued in MI
Practice address
24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340
Phone
(586) 778-1881
Fax
(586) 778-0667
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301087057 MI Primary

Addresses

Primary practice location

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340

Mailing address

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340
Phone (586) 778-1881

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
I20060725000037 MI Practitioner - Internal Medicine 1355354028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waypointe Internal Medicine, P.C.Group PAC ID 8426021866, 5 clinicians

Practice addresses (Care Compare)

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340
Phone (586) 778-1881

Hospital & facility affiliations

  • Health Wise Home Health Care Home health agency, Lathrup Village, MI, CCN 237485
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
96.08
Improvement activities
40
Cost
72.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Waypointe Internal Medicine, P.C. Internal Medicine CurrentSince Dec 7, 2007 Accepting new patients
Kenneth Dziuba MD PC Internal Medicine Past Accepting new patients

Locations

24400 Greater Mack Ave
St Clr Shores, MI 48080
Phone (586) 778-1881

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAEHBA
  • Direct secure messaging: matthew.gill@kdmp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GAEHBA/Endpoint/GAEHBA
  • Direct secure messaging: mgill547202@direct.hfhs.org

Organizations & group practices 2

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 8

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1164469821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24400 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801340",
            "telephone_number": "586-778-1881",
            "fax_number": "586-778-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24400 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801340",
            "telephone_number": "586-778-1881",
            "fax_number": "586-778-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301087057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.