Matthew Alan Fraley, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2004021586 Issued in MO

Practice address

1225 Graham Rd Ste C-2310
Florissant, MO 63031-8023

Phone

(618) 228-4215

NPI assigned

Feb 6, 2007

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Cardiovascular Disease (Cardiology)

Education

Southern Illinois University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
• Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mfraley11239@direct.carenet.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668

  IL

  Medicare reassignment Care Compare group
• Mercy Clinic Adult Hospitalists - St. Louis, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1841235108
  NPD (past)
• Mercy Hospitals East Communities

  dba Mercy St. Louis Transport Ambulance

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish West County Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1831107895
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  dba Christian Hospital

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1326187352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2310",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318023",
            "telephone_number": "618-228-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2310",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318023",
            "telephone_number": "618-228-4215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6810 State Route 162 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628560",
            "country_code": "US",
            "telephone_number": "618-228-4215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2004021586",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-123183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "036.123183",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2004021586",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Graham Rd Ste C-2310",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dionne R Fowler
• Kathy Marie Fowler, MA LPC
• Veeda L. Fowler, MA, LCPC, LPC, NCC
• Abiola Fox, PHARM. D.
• Jamal James Fox, O.D.
• Clinton Frankenbach, MPT
• Frankie Young
• William Franzen Jr., PT
• Erica Frazier
• Wendy Devonne Frazier, M.D.

• Cardiovascular Disease Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.