Active NPI
Rich J. Matthies, M.D.
- Diagnostic Radiology Physician
- Lynnwood, WA
National Provider Identifier
1174597009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD00021639
- Practice address
- 19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746 - Phone
- (425) 563-1500
- Fax
- (425) 563-1501
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00021639 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | MD00021639 | WA | Primary |
Addresses
Primary practice location
19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746
Mailing address
19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4746
Phone (425) 563-1500
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2240480 | Other | AETNA | |
| 109456 | Other | WA | L&I |
| 300065977 | Other | RAILROAD MEDICARE | |
| 8140568 | Medicaid | WA | |
| 8919498 | Other | WA | CRIME VICTIMS |
| 351153 | Other | WA | L&I-RADIA REST OF WA |
| 1004137 | Medicaid | WA | |
| 351175 | Other | WA | L&I-EVERGREEN RADIA |
| MA1945 | Other | WA | REGENCE |
| 351165 | Other | WA | L&I-RADIA KING COUNTY |
| 351172 | Other | WA | L&I-SWEDISH RADIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00021639 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital District No 4 King County Washington | Past | Accepting new patients | |
| Public Hospital District No 4, King County Wa | Past | Accepting new patients | |
| Washington Imaging Services LLC | Specialist | Past | Accepting new patients |
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.
-
- Critical Access Hospital
- Snoqualmie, WA
- NPI 1902846546
-
- Family Medicine Physician
- Snoqualmie, WA
- NPI 1144432634
-
- Specialist
- Bellevue, WA
- NPI 1003880923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489968000000",
"number": "1174597009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 33RD AVE W",
"address_2": "SUITE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364746",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19020 33RD AVE W",
"address_2": "SUITE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364746",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTHIES",
"first_name": "RICH",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2017-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00021639",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD00021639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2240480",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "109456",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300065977",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8140568",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8919498",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-RADIA REST OF WA",
"identifier": "351153",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1004137",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-EVERGREEN RADIA",
"identifier": "351175",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "MA1945",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-RADIA KING COUNTY",
"identifier": "351165",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I-SWEDISH RADIA",
"identifier": "351172",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.