Individual provider Active NPI

Lisa Erin Matos, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1245491869
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
295608 Issued in NY
Practice address
1240 N Mission Rd
Los Angeles, CA 90033
Phone
(323) 226-3416
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A82625 CA
Obstetrics & Gynecology Physician 207V00000X A82625 CA
Anesthesiology Physician 207L00000X 295608 NY Primary

Addresses

Primary practice location

1240 N Mission Rd
Los Angeles, CA 90033

Mailing address

4179 Sunnyslope Ave Apt 102
Sherman Oaks, CA 91423-4360
Phone (818) 430-3228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090124000010 CA Practitioner - Anesthesiology 0840354536 Reassigns benefits to 2 organizations
I20200406001300 FL Practitioner - Anesthesiology 0840354536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3663 S Miami Ave
Miami, FL 33133-4253
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82625CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Quality Care Anesthesia Consultants Inc Anesthesiology CurrentSince Jul 1, 2015 Accepting new patients
Brotman Medical Anesthesia Group Anesthesiology CurrentSince Sep 29, 2013 Accepting new patients

Locations

8641 Wilshire Blvd
Ste 201
Beverly Hills, CA 90211
Phone (310) 289-8600

5700 San Fernando Rd
Glendale, CA 91202
Phone (818) 637-7766

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 2

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1245491869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4179 SUNNYSLOPE AVE APT 102",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914234360",
            "telephone_number": "818-430-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N MISSION RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-226-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS",
        "first_name": "LISA",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A82625",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A82625",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "295608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.