Individual provider Active NPI

Matthew W. Benz, M.D.

  • Pediatrics Physician
  • Southborough, MA
National Provider Identifier
1356369763
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
213223 Issued in MA
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(508) 460-3100
Fax
(508) 460-3180
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 213223 MA Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

24 Newton St
Southborough, MA 01772-1215
Phone (508) 460-3100

Other identifiers 1

IdentifierTypeStateIssuer
0196819MedicaidMA

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
I20070509000493 MA Practitioner - Pediatric Medicine 6507962453 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Reliant Medical Group, Inc Pediatrics CurrentSince Jul 1, 2015 Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Apr 1, 2024 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

111 Grossman Dr
Braintree, MA 02184
Phone (781) 849-1000

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: matthew.benz.npi1356369763.reliant@direct.optumcare.masshiway.net
  • Direct secure messaging: mbenz17846@direct.atrius.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356369763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-460-3100",
            "fax_number": "508-460-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-460-3100",
            "fax_number": "508-460-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZ",
        "first_name": "MATTHEW",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "213223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0196819",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.