Individual provider Active NPI

Keith E Matheny, M.D.

  • Otolaryngology Physician
  • Frisco, TX
National Provider Identifier
1205805462
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
L5828 Issued in TX
Practice address
8380 Warren Parkway
Suite 504
Frisco, TX 75034-4197
Phone
(972) 596-4005
Fax
(972) 985-1253
NPI assigned
Mar 17, 2006
Last updated
Sep 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X L5828 TX Primary

Addresses

Primary practice location

8380 Warren Parkway
Suite 504
Frisco, TX 75034-4197

Mailing address

8380 Warren Parkway
Suite 504
Frisco, TX 75034-4197
Phone (972) 596-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070709000385 TX Practitioner - Otolaryngology 0840390613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical School at Houston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keith E. Matheny, M.D., PLLCGroup PAC ID 3476653247, 4 clinicians

Practice addresses (Care Compare)

8380 Warren Pkwy
Suite 504
Frisco, TX 75034-4253
Phone (972) 596-4005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5828TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keith E. Matheny, M.D., PLLC Otolaryngology CurrentSince May 15, 2007 Accepting new patients
Collin County ENT PA Otolaryngology Past Accepting new patients
Collin County ENT Otolaryngology PastSince May 24, 2022 Accepting new patients

Locations

8380 Warren Pkwy
Ste 504
Frisco, TX 75034
Phone (972) 596-4005

3809 W 15th St
Bldg 700B
Plano, TX 75075
Phone (972) 596-4005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1205805462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 WARREN PARKWAY",
            "address_2": "SUITE 504",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344197",
            "telephone_number": "972-596-4005",
            "fax_number": "972-985-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 WARREN PARKWAY",
            "address_2": "SUITE 504",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344197",
            "telephone_number": "972-596-4005",
            "fax_number": "972-985-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "L5828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.