Randall J Matos DPM PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

193 Issued in OK

Legal business name

RANDALL J MATOS DPM PC

Practice address

1103 Dewey Avenue
Poteau, OK 74953-4411

Phone

(918) 649-3777

Fax

(918) 649-3891

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Randall Joseph Matos, DPMNPI 1780632273

Title

Owner

Phone

(918) 649-3777

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall Joseph Matos, DPM

  • Podiatrist
  • Poteau, OK
  • NPI 1780632273
  Medicare reassignment NPD Authorized official
• Dennis J Carter, D.O.

  • Family Medicine Physician
  • Poteau, OK
  • NPI 1336102532
  NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1407876246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749530400",
            "telephone_number": "918-649-3777",
            "fax_number": "918-649-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 DEWEY AVENUE",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749534411",
            "telephone_number": "918-649-3777",
            "fax_number": "918-649-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL J MATOS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "MATOS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-649-3777",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OK",
            "license": "193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN2101",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200199110A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pro-Care Family Health of Oklahoma , LLC
• Tonia Pruitt
• Lexi Pryor
• Tiffany Puckett, APRN-CNP
• Tina Key Raines, LLC
• Marilyn Kay Rankin, RN
• Kassie Ray
• Rhonda R Ray, M.S., LPC
• Regional Anesthesia SVS LC
• Reimbursement Resource Billing LLC

• Podiatrist in Poteau, OK
• Providers in Poteau, OK by specialty
• Podiatrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.