Individual provider Active NPI

Matthew Kalliath, D.O.

  • Surgery Physician
  • Hyannis, MA
National Provider Identifier
1346623824
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OT016633 Issued in PA
Practice address
105 Park St
Hyannis, MA 02601-5205
Phone
(508) 862-5565
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OT016633 PA Primary

Addresses

Primary practice location

105 Park St
Hyannis, MA 02601-5205

Mailing address

105 Park St
Hyannis, MA 02601-5205
Phone (256) 577-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200831000832 MA Practitioner - General Surgery 5890112247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27 Park St
Hyannis, MA 02601-5230
Phone (508) 771-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.23 of 100Reported as group
Quality
56.78
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy11
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)57
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT016633PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Affiliates of Cape Cod, Inc. Surgery CurrentSince Aug 1, 2020 Accepting new patients
Medical Affiliates of Cape Cod, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Cape Cod Hospital Inc Past Accepting new patients

Locations

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

297 North St
Ste 221
Hyannis, MA 02601
Phone (508) 862-5032

105 Park St
Hyannis, MA 02601
Phone (508) 771-9599

Organizations & group practices 3

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 8

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1346623824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PARK ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026015205",
            "telephone_number": "256-577-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PARK ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026015205",
            "telephone_number": "508-862-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLIATH",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OT016633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.