Individual provider Active NPI

Tiffany Concepcion Matsuo

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1235834888
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R221282 Issued in MD
Practice address
345 Saint Paul St
Baltimore, MD 21202-2123
Phone
(410) 332-9000
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R221282 MD Primary

Addresses

Primary practice location

345 Saint Paul St
Baltimore, MD 21202-2123

Mailing address

345 Saint Paul St
Baltimore, MD 21202-2123
Phone (410) 332-9000

Other practice location 1

1734 York Rd
Lutherville, MD 21093-5606
Phone (410) 252-2273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705000005 MD Practitioner - Nurse Practitioner 1355700709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutherville Hematology and Oncology ServicesGroup PAC ID 6204005325, 19 clinicians
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

1734 York Rd
Lutherville, MD 21093-5606
Phone (410) 494-9099

301 Saint Paul St
Baltimore, MD 21202-2102
Phone (410) 659-2800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.13 of 100Reported as group
Quality
56.5
Promoting interoperability
100
Improvement activities
40
Cost
73.94

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Paul Place Specialists, Inc. CurrentSince May 11, 2023 Accepting new patients
Lutherville Hematology and Oncology Services CurrentSince May 11, 2023 Accepting new patients
St. Paul Place Specialists, Inc. Current Accepting new patients
St Paul Place Specialists Inc CurrentSince May 11, 2023 Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients

Locations

345 Saint Paul St
Baltimore, MD 21202
Phone (410) 332-9594

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

7927 Ritchie Hwy
Glen Burnie, MD 21061
Phone (410) 494-9099

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

1734 York Rd
Timonium, MD 21093
Phone (410) 252-2273

Interoperability endpoints

  • Direct secure messaging: tmaquiling95068@direct.mdmercy.com
  • Direct secure messaging: tmatsuo1314349@direct.umm.edu

Organizations & group practices 5

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": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1235834888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1734 York Rd",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "210935606",
            "country_code": "US",
            "telephone_number": "410-252-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSUO",
        "first_name": "TIFFANY",
        "middle_name": "CONCEPCION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R221282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.