Active NPI
Matthew Kobeszko, M.D.
- Gastroenterology Physician
- Southlake, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- V1812
- Practice address
- 505 S Nolen Dr Ste a
Southlake, TX 76092-9167 - Phone
- (817) 424-1525
- NPI assigned
- Apr 27, 2017
- Last updated
- Jul 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | V1812 | TX | Primary |
Addresses
Primary practice location
505 S Nolen Dr Ste a
Southlake, TX 76092-9167
Mailing address
PO Box 35629
Dallas, TX 75235-0629
Phone (214) 424-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- R Franklin University of Med & Sci/Chicago Medical School, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
505 S Nolen Dr
A
Southlake, TX 76092-9167
Phone (817) 424-1525
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.98 of 100
- Quality
- 66.51
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 71.76
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.73 of 100
- Quality
- 58.78
- Promoting interoperability
- 95
- Improvement activities
- 40
- Cost
- 88.4
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 83 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 390 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V1812 | TX | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Digestive Disease Consultants, PLLC | Gastroenterology | Current | Accepting new patients |
| Texas Digestive Disease Consultants PLLC | Gastroenterology | Current | Accepting new patients |
| Ascension Medical Group-Southeast Wisconsin Inc | Current | Accepting new patients | |
| Texas Digestive Disease Consultants, PLLC | Gastroenterology | Current | Accepting new patients |
Locations
601 S Main St
Keller, TX 76248
Phone (817) 741-4347
505 S Nolen Dr
#A
Southlake, TX 76092
Phone (817) 424-1525
505 S Nolen Dr
Ste A
Southlake, TX 76092
Phone (817) 424-1525
13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400
19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000
9969 S 27th St
Franklin, WI 53132
Phone (414) 325-2229
3811 Spring St
Mount Pleasant, WI 53405
Phone (262) 687-1600
3811 Spring St
Ste 102
Mount Pleasant, WI 53405
Phone (262) 687-5800
201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228
Organizations & group practices 4
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.
-
- Gastroenterology Physician
- Irving, TX
- NPI 1053397331
-
dba Ascension Medical Group
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
-
- Gastroenterology Physician
- Southlake, TX
- NPI 1649256546
-
- Gastroenterology Physician
- Covington, LA
- NPI 1295428415
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baylor Scott & White Medical Center - Grapevine
- General Acute Care Hospital
- Grapevine, TX
- NPI 1073511762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1619402658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35629",
"city": "DALLAS",
"state": "TX",
"postal_code": "752350629",
"telephone_number": "214-424-2200",
"fax_number": "214-231-2159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S NOLEN DR STE A",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760929167",
"telephone_number": "817-424-1525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOBESZKO",
"first_name": "MATTHEW",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "V1812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.