NPIMap

Individual provider Active NPI

Matthew Fernandez, DPM

  • Primary Podiatric Medicine Podiatrist
  • Charleston, SC
National Provider Identifier
1194259341
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
771 Issued in NC
Practice address
1012 Physicians Dr
Charleston, SC 29414-5719
Phone
(843) 571-0602
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 703 SC
Student in an Organized Health Care Education/Training Program 390200000X
Primary Podiatric Medicine Podiatrist 213EP1101X 771 NC Primary
Primary Podiatric Medicine Podiatrist 213EP1101X 703 SC

Addresses

Primary practice location

1012 Physicians Dr
Charleston, SC 29414-5719

Mailing address

150 Chatham Medical Park
Elkin, NC 28621-2445
Phone (336) 835-7676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200812000934 SC Practitioner - Podiatry 2466878152 Reassigns benefits to 1 organization
I20220114002100 NC Practitioner - Podiatry 2466878152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Parkwood Dr
Elkin, NC 28621-2430
Phone (336) 527-3371

180 Parkwood Dr
Elkin, NC 28621-2430
Phone (336) 527-7298

5229 Rock Creek Rd
Hays, NC 28635-9267
Phone (336) 696-2711

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue66
Removal of skin lesions34
Removal of nail tissue269
Removal or shaving of skin growth67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Chatham Memorial Hospital CurrentSince Dec 1, 2021 Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Current Accepting new patients
Hugh Chatham Memorial Hospital, Inc CurrentSince Dec 1, 2021 Accepting new patients
Hugh Chatham Memorial Hospital, Inc Past Accepting new patients

Locations

150 Chatham Medical Park
Elkin, NC 28621
Phone (336) 760-0706

300 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 258-8094

101 Eldon Parks Dr
Ste A
Elkin, NC 28621
Phone (336) 835-2283

360 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-5960

800 Chatham Medical Park
Elkin, NC 28621
Phone (336) 526-4500

5229 Rock Creek Rd
Hays, NC 28635
Phone (336) 696-2711

Interoperability endpoints

  • Direct secure messaging: mfernandez@hcn.gwaydirect.com

Organizations & group practices 5

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 7

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1194259341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CHATHAM MEDICAL PARK",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212445",
            "telephone_number": "336-835-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 PHYSICIANS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145719",
            "telephone_number": "843-571-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "SC",
            "license": "703",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "771",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "SC",
            "license": "703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.