Individual provider Active NPI

Matthew H Noble, DO

  • Family Medicine Physician
  • Salem, OR
National Provider Identifier
1386064178
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO221274 Issued in OR
Practice address
5125 Skyline Rd S
Salem, OR 97306-9413
Phone
(800) 813-2000
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0064900 CO
Family Medicine Physician 207Q00000X DO221274 OR Primary

Addresses

Primary practice location

5125 Skyline Rd S
Salem, OR 97306-9413

Mailing address

559 Vincent St
Peterson Afb, CO 80914-1541

Other practice location 1

559 Vincent St
Peterson AFB, CO 80914-1541
Phone (719) 556-1306

Other identifiers 1

IdentifierTypeStateIssuer
029214OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnectprodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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

Enrollment IDStateProvider typePAC IDDetails
I20240805003178 WA Practitioner - Family Practice 6103113261 Reassigns benefits to 1 organization
I20240806001559 OR Practitioner - Family Practice 6103113261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

5125 Skyline Rd S
Salem, OR 97306-9427
Phone (800) 813-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0064900COMDFamily Medicine Physician
DO221274ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jul 8, 2024 Accepting new patients
Manor Care of Salmon Creek Wa, Association CurrentSince Jul 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 8, 2024 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

5125 Skyline Rd S
Salem, OR 97306
Phone (503) 361-5400

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

14406 NE 20th Ave
Vancouver, WA 98686
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1386064178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 SKYLINE RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069413",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 Vincent St",
            "address_purpose": "LOCATION",
            "city": "Peterson AFB",
            "state": "CO",
            "postal_code": "809141541",
            "country_code": "US",
            "telephone_number": "719-556-1306",
            "fax_number": "719-556-1226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0064900",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO221274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029214",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnectprodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5125 Skyline Rd S",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973069413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.