NPIMap

Individual provider Active NPI

Matthew F Fryzek, M.D.

  • Internal Medicine Physician
  • Council Bluffs, IA
National Provider Identifier
1417020595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33864 Issued in IA
Practice address
201 Ridge St
Suite 202
Council Bluffs, IA 51503-4643
Phone
(712) 325-0022
Fax
(712) 325-8102
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33864 IA Primary

Addresses

Primary practice location

201 Ridge St
Suite 202
Council Bluffs, IA 51503-4643

Mailing address

201 Ridge St
Suite 202
Council Bluffs, IA 51503-4643
Phone (712) 325-0022

Other identifiers 4

IdentifierTypeStateIssuer
2109164OtherUNITED HEALTH CARE
43533OtherIAWELLMARK
0239525MedicaidIA
43533OtherCOVENTRY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070117000513 IA Practitioner - Internal Medicine 6103827118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluffs Family Health Care PCGroup PAC ID 0446298061, 3 clinicians

Practice addresses (Care Compare)

201 Ridge St
Suite 202
Council Bluffs, IA 51503-4643
Phone (712) 396-7711

Hospital & facility affiliations

  • Angels Care Home Health of Iowa Home health agency, Council Bluffs, IA, CCN 167292
  • Aveanna Home Health Home health agency, Council Bluffs, IA, CCN 167226
  • Hillcrest Hospice Hospice, Council Bluffs, IA, CCN 161614
  • Care Initiatives Hospice - Greenfield Hospice, Greenfield, IA, CCN 161595
  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028
  • CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
  • The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040
  • Midlands Living Center L L C Nursing home, Council Bluffs, IA, CCN 165447
  • Bethany Lutheran Home Nursing home, Council Bluffs, IA, CCN 165524
  • North Crest Living Center Nursing home, Council Bluffs, IA, CCN 165290
  • Glen Haven Village Nursing home, Glenwood, IA, CCN 165530
  • Chapters Living of Council Bluffs Nursing home, Council Bluffs, IA, CCN 165466

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33864IAMDInternal Medicine Physician

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417020595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST",
            "address_2": "SUITE 202",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-325-0022",
            "fax_number": "712-325-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST",
            "address_2": "SUITE 202",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-325-0022",
            "fax_number": "712-325-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYZEK",
        "first_name": "MATTHEW",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "33864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2109164",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "43533",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0239525",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "43533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.