Active NPI
Mark Alan Matson, M.D.
- Nephrology Physician
- St. Paul, MN
National Provider Identifier
1447343330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 32891
- Practice address
- 1000 Westgate Drive
Suite 149
St. Paul, MN 55114-5000 - Phone
- (651) 641-2924
- Fax
- (651) 641-2901
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 32891 | MN | Primary |
Addresses
Primary practice location
1000 Westgate Drive
Suite 149
St. Paul, MN 55114-5000
Mailing address
1000 Westgate Drive
Suite 149
St. Paul, MN 55114-5000
Phone (651) 641-2924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32891 | MN | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1447343330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 WESTGATE DRIVE",
"address_2": "SUITE 149",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "551145000",
"telephone_number": "651-641-2924",
"fax_number": "651-641-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 WESTGATE DRIVE",
"address_2": "SUITE 149",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "551145000",
"telephone_number": "651-641-2924",
"fax_number": "651-641-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSON",
"first_name": "MARK",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MN",
"license": "32891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.