NPIMap

Individual provider Active NPI

Matthew Lincoln Tomlin, NP

  • Family Nurse Practitioner
  • Hayward, CA
National Provider Identifier
1215282785
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21689 Issued in CA
Practice address
22331 Mission Blvd
Hayward, CA 94541-3911
Phone
(510) 471-5880
NPI assigned
Jul 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 766206 CA
Family Nurse Practitioner 363LF0000X 21689 CA Primary

Addresses

Primary practice location

22331 Mission Blvd
Hayward, CA 94541-3911

Mailing address

22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 471-5880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140707000217 CA Practitioner - Nurse Practitioner 3072738111 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

222 W 39TH Ave
San Mateo, CA 94403-4364
Phone (650) 573-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
766206CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Nov 12, 2019 Accepting new patients
County of San Mateo CurrentSince Aug 24, 2016 Accepting new patients
County of San Mateo CurrentSince Aug 24, 2016 Accepting new patients
City & County of San Francisco CurrentSince Nov 12, 2019 Accepting new patients
County of San Mateo CurrentSince Aug 24, 2016 Accepting new patients
County of San Mateo Current Accepting new patients
City & County of San Francisco Current Accepting new patients

Locations

380 90th St
Daly City, CA 94015
Phone (650) 301-8600

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

306 Spruce Ave
South San Francisco, CA 94080
Phone (650) 589-9305

Interoperability endpoints

  • Direct secure messaging: mtomlin19615@smch.direct-ci.com

Organizations & group practices 7

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 10

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": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1215282785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "MATTHEW",
        "middle_name": "LINCOLN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "766206",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.