Individual provider Active NPI

Philip Andrew Matorin, M.D.

  • Otolaryngology Physician
  • Houston, TX
National Provider Identifier
1407858384
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
J0103 Issued in TX
Practice address
12121 Richmond Ave Ste 104
Houston, TX 77082-2420
Phone
(281) 920-5558
Fax
(281) 920-5568
NPI assigned
Aug 11, 2005
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X J0103 TX Primary

Addresses

Primary practice location

12121 Richmond Ave Ste 104
Houston, TX 77082-2420

Mailing address

12121 Richmond Ave Ste 104
Houston, TX 77082-2420
Phone (281) 920-5558

Other identifiers 5

IdentifierTypeStateIssuer
86042ZOtherTXRENNAISANCE IPA
741800693OtherUNITED HEALTHCARE
183307101MedicaidTX
8V1030OtherBLUE CROSS
038176601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060824000378 TX Practitioner - OtolaryngologyPractitioner - Sleep MedicinePractitioner - Allergy/Immunology 5597768937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Sleep Medicine
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oprex Medical Group PLLCGroup PAC ID 2769861707, 5 clinicians

Practice addresses (Care Compare)

12121 Richmond Ave
Houston, TX 77082-2420
Phone (281) 920-5558

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oprex Medical Group, PLLC Otolaryngology CurrentSince Jul 10, 2023 Accepting new patients
ENT Associates of Pasadena, PA Otolaryngology Past Accepting new patients

Locations

12121 Richmond Ave
Ste 104
Houston, TX 77082
Phone (281) 920-5558

6699 Chimney Rock Rd
Ste 202
Houston, TX 77081
Phone (281) 920-5558

1213 Hermann Dr
Ste 610
Houston, TX 77004
Phone (281) 985-9362

2615 Southwest Fwy
Ste 290
Houston, TX 77098
Phone (713) 523-8800

Interoperability endpoints

  • Direct secure messaging: pmatorin@direct.meditouchehr.com

Organizations & group practices 3

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 3

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1407858384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822420",
            "telephone_number": "281-920-5558",
            "fax_number": "281-920-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE STE 104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822420",
            "telephone_number": "281-920-5558",
            "fax_number": "281-920-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATORIN",
        "first_name": "PHILIP",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "J0103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENNAISANCE IPA",
            "identifier": "86042Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "741800693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183307101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8V1030",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038176601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.