Individual provider Active NPI

Scott Thomas Matz, MD

  • Urology Physician
  • Vancouver, WA
National Provider Identifier
1295996122
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD61022696 Issued in WA
Practice address
2525 NE 139TH St Ste 220
Vancouver, WA 98686-2719
Phone
(360) 882-2778
Fax
(360) 604-1616
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2008017175 MO
Urology Physician 208800000X 036137930 IL
Urology Physician 208800000X MD61022696 WA Primary

Addresses

Primary practice location

2525 NE 139TH St Ste 220
Vancouver, WA 98686-2719

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone (360) 882-2778

Other practice location 1

611 W. Park St.
Urbana, IL 61801-2500
Phone (217) 383-3160

Other identifiers 1

IdentifierTypeStateIssuer
2155108MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200527003092 WA Practitioner - Urology 4082849484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Missouri, Columbia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008017175MOMDSurgery Physician
036137930ILMDUrology Physician
MD61022696WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jun 22, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jun 22, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince May 24, 2020 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

700 NE 87th Ave
Ste 370
Vancouver, WA 98664
Phone (360) 397-3352

2525 NE 139th St
Ste 220
Vancouver, WA 98686
Phone (360) 397-4437

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: smatz14808@tvc-direct.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 5

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1295996122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 W. Park St.",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012500",
            "country_code": "US",
            "telephone_number": "217-383-3160",
            "fax_number": "217-383-4868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATZ",
        "first_name": "SCOTT",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2008017175",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036137930",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD61022696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155108",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.