Matthew D. Brock, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD60662849 Issued in WA

Practice address

1615 Delaware St
Longview, WA 98632-2367

Phone

(360) 501-3601

Fax

(360) 501-3648

NPI assigned

Apr 26, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Internal Medicine

Education

Oregon Health Sciences University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Serving Hands Medical Center, NPCGroup PAC ID 8921404567, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: matthew.brock@1076018552504324.direct.elationemr.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.

• Serving Hands Medical Center NPC

  • Internal Medicine Physician
  • Washougal, WA
  • NPI 1871266908
  Medicare reassignment Care Compare group Authorized official

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

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1508183948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 SE 11TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027012",
            "telephone_number": "503-915-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322367",
            "telephone_number": "360-501-3601",
            "fax_number": "360-501-3648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10024 SE 32nd Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972226514",
            "country_code": "US",
            "telephone_number": "503-659-4988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCK",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD166695",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60662849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Fredric Brenc, M.D.
• Mary E Brennan, ARNP
• Katrina Elizabeth Brett, DPT
• Jerry Brier
• Lance Dee Brigman, M.D.
• Jillian Shelby Brockmoller
• Todd Broderius, LICSW
• Jesse I Broome, CRNA
• Aaron Mark Brown, M.D.
• Jeffrey Raymond Brown, DDS

• Internal Medicine Physician in Longview, WA
• Providers in Longview, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.