Active NPI
Matthew Wood Stewart, DMD
- Dentist
- Las Cruces, NM
National Provider Identifier
1295256527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD5064
- Practice address
- 1600 Thorpe Rd
Las Cruces, NM 88012-9776 - Phone
- (575) 382-9291
- NPI assigned
- Jun 27, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD5064 | NM | Primary |
| Dentist | 122300000X | DT-2699 | HI |
Addresses
Primary practice location
1600 Thorpe Rd
Las Cruces, NM 88012-9776
Mailing address
PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190814002713 | NM | Order and Referring Only - Dentist | 3577890482 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT-2699 | HI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1295256527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 370",
"city": "HATCH",
"state": "NM",
"postal_code": "879370370",
"telephone_number": "575-267-3280",
"fax_number": "575-267-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 THORPE RD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880129776",
"telephone_number": "575-382-9291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "MATTHEW",
"middle_name": "WOOD",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD5064",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "HI",
"license": "DT-2699",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.