Individual provider Active NPI

Matthew Anthony Monaco, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Wasilla, AK
National Provider Identifier
1235131392
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
142 Issued in AK
Practice address
3465 E. Meridian Park Loop
Suite a
Wasilla, AK 99654
Phone
(907) 373-6670
Fax
(908) 312-2525
NPI assigned
Jun 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 142 AK Primary

Addresses

Primary practice location

3465 E. Meridian Park Loop
Suite a
Wasilla, AK 99654

Mailing address

3465 E. Meridian Park Loop
Suite a
Wasilla, AK 99654
Phone (907) 373-6670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000624 AK Practitioner - Oral Surgery 7416026661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
University of Iowa College of Dentistry, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Matthew a Monaco DDS,LLCGroup PAC ID 7810264603, 2 clinicians

Practice addresses (Care Compare)

3465 E Meridian Park Loop
Suite a
Wasilla, AK 99654-7264
Phone (907) 373-6670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew a Monaco DDS,LLC Oral and Maxillofacial Surgery CurrentSince Apr 1, 2017 Accepting new patients
Summit Oral Surgery LLC Oral and Maxillofacial Surgery PastSince Nov 1, 2007 Accepting new patients
Anesthesia Relief Staffing LLC PastSince Apr 1, 2017 Accepting new patients

Locations

3465 E Meridian Park Loop
Ste A
Wasilla, AK 99654
Phone (907) 242-9864

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 and National Provider Directory roles.

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1235131392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 E. MERIDIAN PARK LOOP",
            "address_2": "SUITE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-6670",
            "fax_number": "908-312-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 E. MERIDIAN PARK LOOP",
            "address_2": "SUITE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-6670",
            "fax_number": "908-312-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONACO",
        "first_name": "MATTHEW",
        "middle_name": "ANTHONY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AK",
            "license": "142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.