Individual provider Active NPI

Matthew Thomas Stib, MD

  • Diagnostic Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1295184687
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
65094 Issued in AZ
Practice address
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone
(480) 301-8000
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267479 MA
Diagnostic Radiology Physician 2085R0202X MD16372 RI
Diagnostic Radiology Physician 2085R0202X 65094 AZ Primary

Addresses

Primary practice location

5777 E Mayo Blvd
Phoenix, AZ 85054-4502

Mailing address

5777 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 301-8000

Other practice location 1

2014 Washington St
Newton Lower Falls, MA 02462-1607
Phone (617) 243-6000

Other practice location 2

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-8755

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mstib1882596@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20211115002887 MA Practitioner - Diagnostic Radiology 5193098960 Reassigns benefits to 3 organizations
I20220126000255 AZ Practitioner - Diagnostic Radiology 5193098960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
George Washington University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267479MAMDInternal Medicine Physician
65094AZMDDiagnostic Radiology Physician
MD16372RIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Aug 12, 2021 Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Dec 27, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Aug 12, 2021 Accepting new patients
Mayo Clinic Arizona CurrentSince Feb 20, 2023 Accepting new patients
Mayo Clinic Arizona CurrentSince Feb 20, 2023 Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

2323 W Rose Garden Ln
Phoenix, AZ 85027
Phone (623) 931-7999

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

16641 N 40th St
Ste 1
Phoenix, AZ 85032
Phone (623) 931-7999

13400 E Shea Blvd
Scottsdale, AZ 85259

9220 E Mountain View Rd
Ste 100
Scottsdale, AZ 85258

3501 N Scottsdale Rd
Ste 130
Scottsdale, AZ 85251

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

1625 N Campbell Ave
Tucson, AZ 85719

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

235 Forest St
Unit 686
Wausau, WI 54402

Interoperability endpoints

  • Direct secure messaging: mstib1882596@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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 2

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1295184687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544502",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2014 Washington St",
            "address_purpose": "LOCATION",
            "city": "Newton Lower Falls",
            "state": "MA",
            "postal_code": "024621607",
            "country_code": "US",
            "telephone_number": "617-243-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-8755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIB",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "267479",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD16372",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "65094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mstib1882596@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850544502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.