Individual provider Active NPI

David Paul Matichak, MD

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
National Provider Identifier
1437845997
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone
(901) 287-6765
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

920 Madison Ave Ste 447
Memphis, TN 38103-3438

Mailing address

847 Monroe Ave RM 427
Memphis, TN 38103-4907
Phone (901) 287-6765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230807003992 TN Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 8325409303

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: david.matichak.1@28653.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1437845997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 MONROE AVE RM 427",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034907",
            "telephone_number": "901-287-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MADISON AVE STE 447",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033438",
            "telephone_number": "901-287-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATICHAK",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.