Individual provider Active NPI

Keron Christopher Matthew, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Brooklyn, NY
National Provider Identifier
1184087082
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
450 Clarkson Ave # 1262
Department of Internal Medicine
Brooklyn, NY 11203-2012
Phone
(718) 270-8867
NPI assigned
Mar 30, 2016
Last updated
Jun 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

450 Clarkson Ave # 1262
Department of Internal Medicine
Brooklyn, NY 11203-2012

Mailing address

450 Clarkson Ave # 1262
Department of Internal Medicine
Brooklyn, NY 11203-2012
Phone (718) 270-8867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906000289 NY Practitioner - HospitalistPractitioner - Internal Medicine 1951644731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 909-9018

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 1, 2019 Accepting new patients
New York University CurrentSince Sep 1, 2019 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Apr 13, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Apr 13, 2020 Accepting new patients

Locations

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7123

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1184087082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 1262",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE # 1262",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEW",
        "first_name": "KERON",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.