Individual provider Active NPI

Matthew Thomas Hoffmann, MD

  • Dermatology Physician
  • Longview, TX
National Provider Identifier
1609132976
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
R2875 Issued in TX
Practice address
1402 N 4TH St
Longview, TX 75601-4774
Phone
(903) 757-8878
Fax
(903) 757-5985
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X R2875 TX Primary

Addresses

Primary practice location

1402 N 4TH St
Longview, TX 75601-4774

Mailing address

5310 Harvest Hill Rd Ste 290
Dallas, TX 75230-5826
Phone (214) 420-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170727003621 TX Practitioner - Dermatology 2365733516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

901 Walnut Hill Dr
Longview, TX 75605-5054
Phone (903) 757-8878

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision144
Removal of skin lesions921
Removal of skin cancer616
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2875TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Aug 1, 2017 Accepting new patients
Dermatology Associates Dermatology Past Accepting new patients

Locations

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

1402 N 4th St
Longview, TX 75601
Phone (903) 234-9992

901 Walnut Hill Dr
Longview, TX 75605
Phone (903) 315-3700

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Interoperability endpoints

  • Direct secure messaging: mhoffmann@dat1977.srs-direct.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1609132976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 HARVEST HILL RD STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752305826",
            "telephone_number": "214-420-0650",
            "fax_number": "214-736-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756014774",
            "telephone_number": "903-757-8878",
            "fax_number": "903-757-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMANN",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "R2875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.