NPIMap

Individual provider Active NPI

Matthew Dale Rodgers

  • Sleep Medicine (Family Medicine) Physician
  • Macon, GA
National Provider Identifier
1578765855
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X
License
95572 Issued in GA
Practice address
1140 S Jackson Springs Rd
Macon, GA 31211-1439
Phone
(478) 238-3552
Fax
(478) 259-6170
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Family Medicine) Physician 207QS1201X 0016970 VT
Sleep Medicine (Family Medicine) Physician 207QS1201X 323034 NY
Sleep Medicine (Family Medicine) Physician 207QS1201X 95572 GA Primary
Family Medicine Physician 207Q00000X 24609 NE

Addresses

Primary practice location

1140 S Jackson Springs Rd
Macon, GA 31211-1439

Mailing address

CMR 402 Unit 33100
Apo, AE 09180
Phone (314) 590-4281

Other practice location 1

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5641
Phone (253) 229-2034

Other practice location 2

CMR 402 Unit 33100
Apo, AE 09180
Phone (314) 590-4281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118001877 WI Practitioner - Sleep Medicine 2163673278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1626 Tuttle St
Baraboo, WI 53913-1501
Phone (608) 355-2033

Hospital & facility affiliations

  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
  • Stoughton Hospital Hospital, Stoughton, WI, CCN 521343

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0016970VTMDSleep Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Nov 11, 2024 Accepting new patients
Dean Health Systems, Inc Family Medicine CurrentSince Nov 11, 2024 Accepting new patients

Locations

1626 Tuttle St
Baraboo, WI 53913
Phone (608) 355-2033

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: mrodgers523139@direct-ehr-ssmhc.com

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 5

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1578765855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "CMR 402 UNIT 33100",
            "city": "APO",
            "state": "AE",
            "postal_code": "09180",
            "telephone_number": "314-590-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S JACKSON SPRINGS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111439",
            "telephone_number": "478-238-3552",
            "fax_number": "478-259-6170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Harmon Ave Ste 1D03",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145641",
            "country_code": "US",
            "telephone_number": "253-229-2034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "CMR 402 Unit 33100",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09180",
            "country_code": "US",
            "telephone_number": "314-590-4281",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "MATTHEW",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "VT",
            "license": "0016970",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "NY",
            "license": "323034",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "GA",
            "license": "95572",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "24609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.