NPIMap

Individual provider Active NPI

Matthew Donavon Forrester, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Spokane, WA
National Provider Identifier
1386805539
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD60349736 Issued in WA
Practice address
62 W 7TH Ave Ste 110
Spokane, WA 99204-2321
Phone
(509) 456-0262
Fax
(509) 462-5059
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD60349736 WA Primary

Addresses

Primary practice location

62 W 7TH Ave Ste 110
Spokane, WA 99204-2321

Mailing address

62 W 7TH Ave Ste 110
Spokane, WA 99204-2321
Phone (509) 456-0262

Other identifiers 2

IdentifierTypeStateIssuer
G8919202OtherWAMEDICARE PTAN
2026075MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mforrester292134@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130626000687 WA Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 3476792201 Reassigns benefits to 2 organizations
I20201014002000 MT Practitioner - Thoracic Surgery 3476792201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
Emory University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services-WaGroup PAC ID 7911069703, 25 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

62 W 7TH Ave
Spokane, WA 99204-2321

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center Current Accepting new patients
Providence Health & Services Mt CurrentSince Oct 15, 2020 Accepting new patients
Providence Health & Services Mt CurrentSince Oct 15, 2020 Accepting new patients
Kadlec Regional Medical Center CurrentSince Oct 1, 2016 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Oct 1, 2016 Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

62 W 7th Ave
Ste 110
Spokane, WA 99204
Phone (509) 462-6485

Organizations & group practices 8

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 2

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1386805539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-456-0262",
            "fax_number": "509-462-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE STE 110",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-456-0262",
            "fax_number": "509-462-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "MATTHEW",
        "middle_name": "DONAVON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD60349736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8919202",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026075",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mforrester292134@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "62 W 7th Ave Ste 110",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.