Benjamin Matsumoto, MD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

2900 N Lake Shore Dr
Medical Staff Office Presence St. Joseph Hospital
Chicago, IL 60657-5640

Phone

(773) 665-3000

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1164554473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "address_2": "MEDICAL STAFF OFFICE PRESENCE ST. JOSEPH HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "address_2": "MEDICAL STAFF OFFICE PRESENCE ST. JOSEPH HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036 063322",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Bernard Matrille, D.C.
• Matrix LLC
• Maria Matsangou, M.D.
• Jordanna Matsoff, APN
• Jeffrey W. Matson, APN-CRNA
• Edward J. Matsumoto, DDS
• Michael Yoichi Matsumoto, DDS
• Sara Matsumoto
• Shinichi Matsuo, L.AC.
• Matt Ambrose LLC

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.