NPIMap

Individual provider Active NPI

Matthew Vasko, M.D.

  • Pain Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1275845588
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
4301097093 Issued in MI
Practice address
21000 E 12 Mile Rd
Suite 100
Saint Clair Shores, MI 48081-1116
Phone
(313) 343-4370
NPI assigned
Jul 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301097093 MI
Pain Medicine Physician 208VP0000X 4301097093 MI Primary

Addresses

Primary practice location

21000 E 12 Mile Rd
Suite 100
Saint Clair Shores, MI 48081-1116

Mailing address

21000 E 12 Mile Rd
Suite 100
Saint Clair Shores, MI 48081-1116
Phone (313) 343-4370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728004242 MI Practitioner - Pain ManagementPractitioner - Anesthesiology 1052543998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Saint Louis University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Blue Water Pain Specialists PCGroup PAC ID 9537392188, 4 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

22101 Moross Rd
Detroit, MI 48236-2148
Phone (313) 343-4000

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score
20.78 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
69.28

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Pain Specialists PC Pain Medicine CurrentSince Aug 10, 2015 Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
Ste 100
Detroit, MI 48236

21000 E 12 Mile Rd
Ste 100
St Clr Shores, MI 48081
Phone (313) 343-4370

Interoperability endpoints

  • Direct secure messaging: mvasko1156454@direct.hfhs.org

Organizations & group practices 2

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 6

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1275845588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811116",
            "telephone_number": "313-343-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811116",
            "telephone_number": "313-343-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASKO",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301097093",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "4301097093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.