Individual provider Active NPI

Matthew Jordan Dickson, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Glens Falls, NY
National Provider Identifier
1528021706
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
244280 Issued in NY
Practice address
14 Hudson Avenue
Adirondack ENT
Glens Falls, NY 12801-4363
Phone
(518) 926-1380
Fax
(518) 926-1385
NPI assigned
Apr 10, 2006
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 244280 NY Primary
Facial Plastic Surgery Physician 207YS0123X 57061 GA

Addresses

Primary practice location

14 Hudson Avenue
Adirondack ENT
Glens Falls, NY 12801-4363

Mailing address

100 Park Street
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801-4413
Phone (518) 926-5924

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.dickson@cdirectglensfallshosp.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070927000058 NY Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9133123268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Tufts University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000

14 Hudson Ave
Glens Falls, NY 12801-4448
Phone (518) 926-1380

79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.44
Promoting interoperability
97.95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57061GAMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc. Otolaryngology/Facial Plastic Surgery CurrentSince Nov 3, 2014 Accepting new patients
Glens Falls Hospital Inc CurrentSince Nov 3, 2014 Accepting new patients
New York Pain Management PLLC PastSince Apr 14, 2003 Accepting new patients

Locations

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

2 Broad Street Plz
Glens Falls, NY 12801
Phone (518) 793-0519

79 North St
Granville, NY 12832
Phone (518) 642-0612

Interoperability endpoints

  • Direct secure messaging: matthew.dickson@cdirectglensfallshosp.org
  • Direct secure messaging: mdickson97951@albanymed.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1528021706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-5924",
            "fax_number": "518-926-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 HUDSON AVENUE",
            "address_2": "ADIRONDACK ENT",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014363",
            "telephone_number": "518-926-1380",
            "fax_number": "518-926-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "MATTHEW",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "244280",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "GA",
            "license": "57061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.dickson@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "14 Hudson Avenue",
            "address_2": "Adirondack ENT",
            "city": "Glens Falls",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128014363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.