Individual provider Active NPI

Matthew Eidem, MD

  • Gastroenterology Physician
  • Plano, TX
National Provider Identifier
1376650366
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
L3290 Issued in TX
Practice address
3242 Preston Rd Ste 200
Plano, TX 75093-3311
Phone
(972) 867-0019
Fax
(972) 867-7785
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X L3290 TX Primary

Addresses

Primary practice location

3242 Preston Rd Ste 200
Plano, TX 75093-3311

Mailing address

7610 N Stemmons Fwy Ste 600
Dallas, TX 75247-4228
Phone (214) 689-5960

Other identifiers 2

IdentifierTypeStateIssuer
158659603MedicaidTX
8B4613OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070518000419 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 0345347720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Minnesota Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

3242 Preston Rd
Suite 200
Plano, TX 75093-3328
Phone (972) 867-0019

5425 W Spring Creek Pkwy
Suite 205
Plano, TX 75024-4236
Phone (972) 526-5860

7150 N President George Bush Hwy
Suite 201
Garland, TX 75044-2210
Phone (972) 771-2222

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Hospital & facility affiliations

  • Medical City Plano Hospital, Plano, TX, CCN 450651

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy95
Upper gastrointestinal (GI) endoscopy for acid reflux123

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants PLLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Texas Digestive Disease Consultants, PLLC Gastroenterology Current Accepting new patients

Locations

4521 Medical Center Dr
Ste 500
McKinney, TX 75069
Phone (972) 398-0393

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

3242 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 867-0019

7501 Lakeview Pkwy
Ste 260
Rowlett, TX 75088
Phone (972) 475-8183

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 1

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1376650366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 N STEMMONS FWY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474228",
            "telephone_number": "214-689-5960",
            "fax_number": "469-713-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 PRESTON RD STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750933311",
            "telephone_number": "972-867-0019",
            "fax_number": "972-867-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEM",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "L3290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158659603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8B4613",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.