Individual provider Active NPI

Matthew William Ryzewski, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Manchester, NH
National Provider Identifier
1548495468
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
17029 Issued in NH
Practice address
1 Elliot Way
Nicu
Manchester, NH 03103-3502
Phone
(603) 663-2692
Fax
(603) 663-3982
NPI assigned
May 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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
Neonatal-Perinatal Medicine Physician 2080N0001X 17029 NH Primary

Addresses

Primary practice location

1 Elliot Way
Nicu
Manchester, NH 03103-3502

Mailing address

1 Elliot Way
Nicu
Manchester, NH 03103-3502
Phone (603) 663-2692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20150831000575 NH Practitioner - Pediatric Medicine 7810203361 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17029NHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services Neonatal-Perinatal Medicine CurrentSince Jul 31, 2015 Accepting new patients
Elliot Hospital of the City of Manchester Past Accepting new patients

Locations

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 2

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1548495468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "address_2": "NICU",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-2692",
            "fax_number": "603-663-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "address_2": "NICU",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-2692",
            "fax_number": "603-663-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYZEWSKI",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-20",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NH",
            "license": "17029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.