Individual provider Active NPI

Matthew Mark Balocco, DO

  • Emergency Medicine Physician
  • Chandler, AZ
National Provider Identifier
1487407987
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R4370 Issued in AZ
Practice address
1955 W Frye Rd
Chandler, AZ 85224-6282
Phone
(480) 728-3000
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X R4370 AZ Primary

Addresses

Primary practice location

1955 W Frye Rd
Chandler, AZ 85224-6282

Mailing address

1955 W Frye Rd
Chandler, AZ 85224-6282
Phone (480) 728-3000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240715001344 AZ Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 1557806536

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1487407987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 W FRYE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246282",
            "telephone_number": "480-728-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W FRYE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246282",
            "telephone_number": "480-728-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOCCO",
        "first_name": "MATTHEW",
        "middle_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R4370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.