NPIMap

Individual provider Active NPI

Matthew Dallos, M.D.

  • Hematology & Oncology Physician
  • New York, NY
National Provider Identifier
1578825071
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
279931-1 Issued in NY
Practice address
161 Fort Washington Ave
New York, NY 10032-3729
Phone
(212) 305-5874
Fax
(212) 305-6762
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 279931 NY
Hematology & Oncology Physician 207RH0003X 279931-1 NY Primary

Addresses

Primary practice location

161 Fort Washington Ave
New York, NY 10032-3729

Mailing address

630 W 168TH St # 4
New York, NY 10032-3725
Phone (212) 305-5874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190726002797 NY Practitioner - Medical Oncology 9133465743 Reassigns benefits to 2 organizations
I20240801000880 NJ Practitioner - Medical Oncology 9133465743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Solid Tumor GroupGroup PAC ID 4082503354, 233 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10021-6007
Phone (212) 639-2131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
80.94
Improvement activities
40
Cost
65.19

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
60.62
Improvement activities
40
Cost
73.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279931NYMDInternal Medicine Physician
279931-1NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Solid Tumor Group Internal Medicine CurrentSince Oct 31, 2022 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Jun 15, 2019 Accepting new patients
MSK Monmouth CurrentSince May 23, 2024 Accepting new patients

Locations

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

177 Fort Washington Ave
#6
New York, NY 10032
Phone (212) 305-0983

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1578825071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-5874",
            "fax_number": "212-305-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323729",
            "telephone_number": "212-305-5874",
            "fax_number": "212-305-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLOS",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "279931",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "279931-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.