Bertram T Matsumoto, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

24096 Issued in AZ

Practice address

3200 S Country Club Way
Tempe, AZ 85282-4054

Phone

(480) 839-0206

Fax

(480) 839-0208

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Ophthalmology

Education

Washington University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmic Surgeons and Physicians LTDGroup PAC ID 1052309374, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.05 of 100Reported as group

Promoting interoperability

93

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmatsumoto@osp.emadirect.md

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.

• Ophthalmic Surgeons & Physicians LTD

  • Ophthalmology Physician
  • Tempe, AZ
  • NPI 1689648925
  Medicare reassignment Care Compare group NPD
• Matthew R Sullivan OD

  • Optometrist
  • Prescott, AZ
  • NPI 1285813360
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1477557494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S COUNTRY CLUB WAY",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824054",
            "telephone_number": "480-839-0206",
            "fax_number": "480-839-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S COUNTRY CLUB WAY",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852824054",
            "telephone_number": "480-839-0206",
            "fax_number": "480-839-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "BERTRAM",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "24096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0393470",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358988",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6536800",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robyn Mathews, DPT
• Morgan Fullmer Mathie, D.O.
• Mark A. Mathurin, MD
• Larry Allen Matje, LPC
• Matread Care, LLC
• Emiko Grace Matsumoto
• Matthew a Wade PLLC
• Matthew Colby, DC, PLLC
• Nicole Renee Matthews
• Tianna Matthews, LAC

• Ophthalmology Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.