Active NPI
Matthew Christian Metzger, MD
- Student in an Organized Health Care Education/Training Program
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD61563032 | WA | |
| Student in an Organized Health Care Education/Training Program | 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, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61563032 | WA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-Columbia Medical Center | Single Specialty | Current | Accepting new patients |
| Healthcare for the Mid-Columbia Region | Single Specialty | Current | Accepting new patients |
| Peacehealth | Single Specialty | Current | Accepting new patients |
| Mid-Columbia Medical Center | Single Specialty | Current | Accepting new patients |
| Mid-Columbia Medical Center | Single Specialty | Current | 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
- 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.
-
- General Practice Physician
- The Dalles, OR
- NPI 1053409599
Single Specialty
-
- Emergency Medicine Physician
- The Dalles, OR
- NPI 1497797856
Single Specialty
-
- Rural Health Clinic/Center
- The Dalles, OR
- NPI 1154351336
Single Specialty
-
- General Acute Care Hospital
- Longview, WA
- NPI 1073510277
-
- Physical Therapist
- Longview, WA
- NPI 1275501538
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.