Active NPI
Matthew Thomas Kingery, MD
- Orthopaedic Surgery Physician
- Chicago, IL
National Provider Identifier
1255951224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036179858
- Practice address
- 1611 W Harrison St Ste 400
Chicago, IL 60612-4861 - Phone
- (877) 632-6637
- Fax
- (708) 409-5179
- NPI assigned
- Apr 20, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 01100065A | IN | |
| Orthopaedic Surgery Physician | 207X00000X | 036179858 | IL | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 01100065A | IN | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 036179858 | IL |
Addresses
Primary practice location
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Mailing address
PO Box 735263
Chicago, IL 60673-5263
Other practice location 1
550 1st Ave
New York, NY 10016-6402
Phone (212) 263-5506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
377 E 33Rd St
Apt 4N
New York, NY 10016-9486
PO Box
Suite 393
Seekonk, MA 02771
PO Box
Suite 393
Seekonk, MA 02771-0393
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036179858 | IL | MD | Orthopaedic Surgery Physician |
| 01100065A | IN | MD | Orthopaedic Surgery Physician |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1255951224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735263",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "877-632-6637",
"fax_number": "708-409-5179"
}
],
"practiceLocations": [
{
"address_1": "550 1st Ave",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100166402",
"country_code": "US",
"telephone_number": "212-263-5506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KINGERY",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-20",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IN",
"license": "01100065A",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036179858",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IN",
"license": "01100065A",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IL",
"license": "036179858",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.