Individual provider Active NPI

Michael Matrale, D.O.

  • Internal Medicine Physician
  • Stratford, NJ
National Provider Identifier
1205249174
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB10095800 Issued in NJ
Practice address
42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354
Phone
(856) 566-2753
NPI assigned
Jun 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MB10095800 NJ Primary

Addresses

Primary practice location

42 E Laurel Rd
Suite 3100
Stratford, NJ 08084-1354

Mailing address

151 Fries Mill Rd Ste 301
Turnersville, NJ 08012-2016
Phone (856) 513-4124

Other practice location 1

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

Other practice location 2

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170717000299 NJ Practitioner - Internal Medicine 2264702752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10095800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. Internal Medicine CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jul 1, 2017 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jul 1, 2017 Accepting new patients
Jefferson University Physicians Internal Medicine Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

151 Fries Mill Rd
Ste 301
Turnersville, NJ 08012
Phone (856) 374-1881

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1402185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205249174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD STE 301",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122016",
            "telephone_number": "856-513-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E LAUREL RD",
            "address_2": "SUITE 3100",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841354",
            "telephone_number": "856-566-2753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Chapel Ave W",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022048",
            "country_code": "US",
            "telephone_number": "856-513-4124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 Hurffville Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122453",
            "country_code": "US",
            "telephone_number": "856-513-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATRALE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10095800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.