NPIMap

Individual provider Active NPI

Lincoln Spencer Matheson, MD

  • Neuroradiology Physician
  • Show Low, AZ
National Provider Identifier
1477905545
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
64850 Issued in AZ
Practice address
2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone
(928) 537-6338
NPI assigned
Jul 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301110752 MI
Neuroradiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085N0700X 64850 AZ Primary

Addresses

Primary practice location

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831

Mailing address

PO Box 847
Show Low, AZ 85902-0847
Phone (928) 537-6338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220617001338 AZ Practitioner - Diagnostic Radiology 5294012134 Reassigns benefits to 2 organizations
I20220926000345 TX Practitioner - Diagnostic Radiology 5294012134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS IHS Phoenix AreaGroup PAC ID 2668649567, 72 clinicians
Summit Healthcare AssociationGroup PAC ID 3779568647, 78 clinicians
DHHS IHS Phoenix AreaGroup PAC ID 9436325420, 31 clinicians
White Mountain RadiologyGroup PAC ID 2365429123, 21 clinicians

Practice addresses (Care Compare)

200 W Hospital Dr
860 Whiteriver Indian
Whiteriver, AZ 85941-0860
Phone 92833849113532

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-4375

264 Hwy
Polacca, AZ 86042
Phone (928) 737-6000

4951 S White Mountain Rd
Show Low, AZ 85901-7827
Phone (928) 537-6700

Hospital & facility affiliations

  • Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062
  • Whiteriver PHS Indian Hospital Hospital, Whiteriver, AZ, CCN 030113
  • Hopi Health Care Center Hospital, Polacca, AZ, CCN 031305
  • Cobre Valley Regional Medical Center Hospital, Globe, AZ, CCN 031314
  • White Mountain Regional Medical Center Hospital, Springerville, AZ, CCN 031315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110752MIMDInternal Medicine Physician
64850AZMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Mountain Radiology Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
DHHS IHS Phoenix Area Single Specialty CurrentSince Jun 23, 2022 Accepting new patients
Summit Healthcare Association CurrentSince Jun 1, 2022 Accepting new patients
DHHS IHS Phoenix Area Single Specialty CurrentSince Aug 16, 2022 Accepting new patients
Summit Healthcare Association Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
DHHS IHS Phoenix Area Single Specialty CurrentSince Jun 23, 2022 Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

4951 S White Mountain Rd
Show Low, AZ 85901
Phone (928) 532-5848

Organizations & group practices 9

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 9

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

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1477905545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859020847",
            "telephone_number": "928-537-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "LINCOLN",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301110752",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "AZ",
            "license": "64850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.