Matthew G Kanaan, DO , MS

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

2010-01482 Issued in NC

Practice address

3237 Blue Ridge Rd
Raleigh, NC 27612

Phone

(919) 781-7500

NPI assigned

Apr 6, 2009

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Sports Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthcare Direct PLLCGroup PAC ID 4385039338, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkanaando@wimc.trimed.direct-ci.com

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.

• Healthcare Direct, PLLC

  • Sports Medicine (Family Medicine) Physician
  • Raleigh, NC
  • NPI 1477215358
  Medicare reassignment Care Compare group NPD Authorized official
• Wake Internal Medicine Consultants, Inc.

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1699760926
  Medicare reassignment NPD

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1508008574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 BLUE RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-781-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAAN",
        "first_name": "MATTHEW",
        "middle_name": "G",
        "credential": "DO , MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-06",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2010-01482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamm McKenzie OBGYN, PLLC
• Kamm McKenzie Obstetrics & Gynecology, PLLC
• Rick Rande Kamm, MD
• Amandip Kamoh, DDS
• Kelly Dean Kamp, M.D.
• Abed Sharif Kanaana, CNIM
• Laura C Kanai, LPC
• Ann Margaret Kane Ferguson, RD
• Colleen Reilly Kane, OTR/L
• Lisa M. Kane, M.S.N, R.N., C.S.

• Sports Medicine (Family Medicine) Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Sports Medicine (Family Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.