Individual provider Active NPI

Matthew Muecke, MD

  • Emergency Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1376963488
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101262655 Issued in VA
Practice address
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone
(703) 523-1000
NPI assigned
Apr 16, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101262655 VA Primary

Addresses

Primary practice location

2300 Opitz Blvd
Woodbridge, VA 22191-3311

Mailing address

550 14TH Rd S Apt 1421
Arlington, VA 22202-7416
Phone (865) 414-8324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190515001263 TN Practitioner - Emergency Medicine 9638440597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone (865) 544-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101262655VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Apr 13, 2024 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Hospital Based Medical Services of Tennessee-I PC Emergency Medicine PastSince Feb 20, 2019 Accepting new patients
North Carolina Em I Medical Services P C Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

391 Wallace Rd
Nashville, TN 37211
Phone (615) 332-6253

12825 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 523-9800

2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000

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

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376963488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 14TH RD S APT 1421",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222027416",
            "telephone_number": "865-414-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "703-523-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUECKE",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101262655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.