Elycia R Matushin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

56637 Issued in MN

Practice address

1020 W Broadway Ave
Minneapolis, MN 55411-2504

Phone

(612) 302-8200

Fax

(612) 302-8275

NPI assigned

Apr 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Family Practice

Education

Sanford School of Medicine of University of South Dakota, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ematushin82915@direct.northmemorial.com

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.

• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group NPD
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Rogers, MN
  • NPI 1124210760
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Lino Lakes, MN
  • NPI 1538313796
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD
• University of Minnesota Physicians

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD
• Cardiothoracic Surgery Clinic of North Ms

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tupelo, MS
  • NPI 1154533321
  NPD (past)

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

{
    "created_epoch": "1335052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255698783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FREEPORT AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302723",
            "telephone_number": "763-581-5200",
            "fax_number": "763-581-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W BROADWAY AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112504",
            "telephone_number": "612-302-8200",
            "fax_number": "612-302-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUSHIN",
        "first_name": "ELYCIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "56637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Mattson, MD
• Lauren Mattson, CNM, DNP
• Nirmalla Singh Mattson, CNP, CNS
• Sarah Ann Mattson, PT
• Scott A Mattson, PT
• Laura Matuszewska
• Jason Michael Matz
• Mark Matzek, RN
• Bridget Matzinger
• Sheldon Michael Mauer, MD

• Family Medicine Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.