Individual provider Active NPI

Matthew Gerard Pascual, DO

  • Pediatrics Physician
  • Anchorage, AK
National Provider Identifier
1477059079
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
179385 Issued in AK
Practice address
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Phone
(907) 729-3300
NPI assigned
Apr 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 179385 AK Primary
Student in an Organized Health Care Education/Training Program 390200000X FL

Addresses

Primary practice location

4320 Diplomacy Dr
Anchorage, AK 99508-5925

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-7408

Other practice location 1

841 Prudential Dr Ste 1130
Jacksonville, FL 32207-8331
Phone (904) 633-4188

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
I20211103002185 TX Practitioner - Osteopathic Manipulative Medicine 3375931785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcentral FoundationGroup PAC ID 5496663627, 168 clinicians

Practice addresses (Care Compare)

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

Merit-based Incentive Payment System (MIPS)

Final score
91.77 of 100Reported as group
Quality
76.11
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Foundation CurrentSince Oct 1, 2021 Accepting new patients
Southcentral Foundation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Oct 1, 2021 Accepting new patients
Southcentral Foundation Past Accepting new patients

Locations

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1477059079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-7408",
            "fax_number": "907-729-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085925",
            "telephone_number": "907-729-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "841 Prudential Dr Ste 1130",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078331",
            "country_code": "US",
            "telephone_number": "904-633-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "MATTHEW",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AK",
            "license": "179385",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.