Individual provider Active NPI

Matous Pradny, MD

  • Internal Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1255535779
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
EMC0006119 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 985-4632
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301088348 MI
Internal Medicine Physician 207R00000X 01066616A IN
Student in an Organized Health Care Education/Training Program 390200000X 4301088348 MI
Internal Medicine Physician 207R00000X EMC0006119 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 985-4632

Other practice location 1

5215 Holy Cross Parkway
Mishawaka, IN 46545-1469
Phone (574) 237-7111

Other practice location 2

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 985-4632

Other identifiers 1

IdentifierTypeStateIssuer
000000626995OtherINBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MI, VI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20090804000254 IN Practitioner - HospitalistPractitioner - Internal Medicine 9537212899 Reassigns benefits to 2 organizations
I20241216002177 MI Practitioner - Internal Medicine 9537212899 Reassigns benefits to 1 organization
I20250303001161 VI Practitioner - Internal Medicine 9537212899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians
VI Government Hospital and Health Facilities CorpGroup PAC ID 6204722879, 36 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

9048 Sugar Est
St Thomas, VI 00802-3634
Phone (340) 776-8311

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Roy Lester Schneider Hospital,the Hospital, St Thomas, VI, CCN 480001
  • Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Merit-based Incentive Payment System (MIPS)

Final score
66.61 of 100Reported as individual
Quality
68.35
Improvement activities
0
Cost
71.8

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301088348MIMDInternal Medicine Physician
EMC0006119MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices Internal Medicine CurrentSince Dec 12, 2024 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Dec 12, 2024 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Oct 5, 2019 Accepting new patients
Saint Joseph Regional Medical Center, Inc. Internal Medicine Past Accepting new patients

Locations

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: mpradny1147643@direct.trinity-health.org

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Comfort 1 Hospice LLCSouth Bend, IN, CCN 151629 Hospice 5% Or Greater Direct Ownership Interest (17%) Dec 31, 2017

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 6

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 3

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1255535779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 HOLY CROSS PARKWAY",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465451469",
            "country_code": "US",
            "telephone_number": "574-237-7111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 N Saint Joseph Ave",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491202207",
            "country_code": "US",
            "telephone_number": "269-985-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRADNY",
        "first_name": "MATOUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301088348",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01066616A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301088348",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "EMC0006119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000626995",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.