Organization Active NPI

Lotus Primary Care PLLC

  • Family Medicine Physician
  • Brewster, MA
National Provider Identifier
1174436430
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LOTUS PRIMARY CARE PLLC
Practice address
125 Underpass Rd
Brewster, MA 02631-1810
Phone
(508) 625-6963
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Matthew Libby, DONPI 1538421938
Title
Owner
Phone
(508) 625-6963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU

Addresses

Primary practice location

125 Underpass Rd
Brewster, MA 02631-1810

Mailing address

125 Underpass Rd
Brewster, MA 02631-1810
Phone (508) 625-6963

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2336341Lotus Primary Care, PLLC125 Underpass Rd, Brewster, MA 02631Certificate of waiverDec 30, 2027

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1174436430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 UNDERPASS RD",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026311810",
            "telephone_number": "508-625-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 UNDERPASS RD",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026311810",
            "telephone_number": "508-625-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "LIBBY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-625-6963",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.

Verify at the official NPI Registry.