Individual provider Active NPI

Matthew Christian Metzger, MD

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1396374898
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5270
Phone
(410) 601-7639
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD61563032 WA
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5270

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5270
Phone (410) 601-7639

Other practice location 1

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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
I20230727002168 OR Practitioner - Pediatric Medicine 2769805944 Reassigns benefits to 1 organization
I20240802002422 WA Practitioner - Pediatric Medicine 2769805944 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61563032WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Healthcare for the Mid-Columbia Region Single Specialty Current Accepting new patients
Peacehealth Single Specialty CurrentSince Sep 9, 2024 Accepting new patients
Mid-Columbia Medical Center Single Specialty Current Accepting new patients
Mid-Columbia Medical Center Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Peacehealth Past Accepting new patients
Peacehealth Past Accepting new patients

Locations

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1935 E 19th St
The Dalles, OR 97058
Phone (541) 223-9018

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

Interoperability endpoints

  • Direct secure messaging: mmetzger663144@direct.peacehealth.org

Organizations & group practices 7

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1396374898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155270",
            "telephone_number": "410-601-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155270",
            "telephone_number": "410-601-7639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322367",
            "country_code": "US",
            "telephone_number": "360-414-2385",
            "fax_number": "360-414-2386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METZGER",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61563032",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.