Active NPI
Matthew Shane Dawson, MD
- Surgery Physician
- New York, NY
National Provider Identifier
1487758900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 225166
- Practice address
- 111 E 75TH St Ofc 1a
New York, NY 10021-2816 - Phone
- (212) 744-1100
- Fax
- (646) 688-5125
- NPI assigned
- Sep 13, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 225166 | NY | Primary |
Addresses
Primary practice location
111 E 75TH St Ofc 1a
New York, NY 10021-2816
Mailing address
111 E 75TH St Ofc 1a
New York, NY 10021-2816
Phone (212) 744-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225166 | Other | NY | LIC |
| BD7909875 | Other | DEA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2022 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LHHN Medical, P.C. | Surgery | Past | Accepting new patients |
Interoperability endpoints
- mdawson364747@northwell.direct-ci.com
Organizations & group practices 1
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": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1487758900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E 75TH ST OFC 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212816",
"telephone_number": "212-744-1100",
"fax_number": "877-732-3203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 75TH ST OFC 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212816",
"telephone_number": "212-744-1100",
"fax_number": "646-688-5125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "MATTHEW",
"middle_name": "SHANE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "225166",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIC",
"identifier": "225166",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEA",
"identifier": "BD7909875",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.