Matthew Gormley, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301090708 Issued in MI

Practice address

8 N Howard Ave
Croswell, MI 48422-1221

Phone

(810) 679-0012

Fax

(810) 679-0004

NPI assigned

Sep 12, 2007

Last updated

Feb 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Wayne State University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McKenzie Memorial HospitalGroup PAC ID 6406755289, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McKenzie Health System Hospital, Sandusky, MI, CCN 231314
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.gormley@mhs.eclinicaldirectplus.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• McKenzie Memorial Hospital

  dba McKenzie Health System

  • Critical Access Hospital
  • Sandusky, MI
  • NPI 1497750608

  Corporate Director

  CMS ownership
• McKenzie Memorial Hospital

  dba McKenzie Health & Wellness

  • Rural Health Clinic/Center
  • Sandusky, MI
  • NPI 1932747946

  Corporate Director

  CMS ownership

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.

• McKenzie Memorial Hospital

  dba McKenzie Health System

  • Critical Access Hospital
  • Sandusky, MI
  • NPI 1497750608
  Medicare reassignment Care Compare group NPD
• Sciometrix LLC

  • General Practice Physician
  • Royal Oak, MI
  • NPI 1619649894
  Medicare reassignment NPD
• McKenzie Memorial Hospital

  dba Peck Medical Center

  • Rural Health Clinic/Center
  • Peck, MI
  • NPI 1437917598
  NPD
• Sciometrix Inc

  • General Practice Physician
  • Staten Island, NY
  • NPI 1457065591
  NPD
• McKenzie Memorial Hospital

  dba McKenzie Professional Practice

  • Family Medicine Physician
  • Sandusky, MI
  • NPI 1831443761

  Internal Medicine

  NPD (past)
• McKenzie Memorial Hospital

  dba McKenzie Health & Wellness

  • Rural Health Clinic/Center
  • Sandusky, MI
  • NPI 1932747946
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McKenzie Memorial Hospital

  dba McKenzie Health System

  • Critical Access Hospital
  • Sandusky, MI
  • NPI 1497750608
  Care Compare affiliation
• McKenzie Memorial Hospital

  dba McKenzie Professional Practice

  • Family Medicine Physician
  • Sandusky, MI
  • NPI 1831443761

  Hospital

  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1235324385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N HOWARD AVE",
            "address_2": "SUITE 525",
            "city": "CROSWELL",
            "state": "MI",
            "postal_code": "484221221",
            "telephone_number": "810-679-0012",
            "fax_number": "810-679-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N HOWARD AVE",
            "city": "CROSWELL",
            "state": "MI",
            "postal_code": "484221221",
            "telephone_number": "810-679-0012",
            "fax_number": "810-679-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301090708",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.gormley@mhs.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "8 N Howard Ave",
            "city": "Croswell",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484221221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carissa Fenner
• Maija Matintytar Fenner
• Samantha Lee Garcia
• Patrick Gonczar
• Julie Gordon
• Madison Griffith
• Corrine Holsbeke, DDS
• Todd J Hook, R.PH.
• Jerry J Hosterman, LMSW
• Richard Raymond Hug, LBSW

• Internal Medicine Physician in Croswell, MI
• Providers in Croswell, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.