Individual provider Active NPI

Matthew Robert Flaherty, MD

  • Neurocritical Care Physician
  • Phoenix, AZ
National Provider Identifier
1265797401
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
50168 Issued in AZ
Practice address
250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone
(480) 331-6721
NPI assigned
Jul 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME114563 FL
Neurology Physician 2084N0400X 50168 AZ
Neurocritical Care Physician 2084A2900X 50168 AZ Primary

Addresses

Primary practice location

250 E Dunlap Ave
Phoenix, AZ 85020-2825

Mailing address

111 E Dunlap Ave
Suite 1-279
Phoenix, AZ 85020-2807

Other identifiers 2

IdentifierTypeStateIssuer
14QW2OtherFLBLUE CROSS BLUE SHIELD
009047300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20150602001515 AZ Practitioner - Critical Care (Intensivists)Practitioner - Neurology 5092956722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50168AZMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurocritical Care and Stroke of Arizona PLLC Neurology CurrentSince May 1, 2015 Accepting new patients
Honorhealth Ambulatory Current Accepting new patients
Honorhealth Ambulatory Neurology CurrentSince Sep 12, 2022 Accepting new patients
Honorhealth Ambulatory CurrentSince Sep 12, 2022 Accepting new patients

Locations

19829 N 27th Ave
Phoenix, AZ 85027
Phone (602) 879-5720

111 E Dunlap Ave
Ste 1279
Phoenix, AZ 85020
Phone (480) 331-6721

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

3198 N Windsong Dr
Prescott Vly, AZ 86314
Phone (480) 596-1110

7301 E 2nd St
Ste 210
Scottsdale, AZ 85251
Phone (480) 534-4515

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

Organizations & group practices 4

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1265797401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E DUNLAP AVE",
            "address_2": "SUITE 1-279",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202825",
            "telephone_number": "480-331-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHERTY",
        "first_name": "MATTHEW",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME114563",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "50168",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "AZ",
            "license": "50168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14QW2",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009047300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.