Active NPI
Matthew Stewart Lebo, PHD
- Clinical Molecular Genetics Physician
- Cambridge, MA
National Provider Identifier
1629347968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Molecular Genetics Physician
- License
- 2011105
- Practice address
- 65 Landsdowne St
Cambridge, MA 02139-4232 - Phone
- (617) 768-8292
- NPI assigned
- Dec 15, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Molecular Genetics Physician | 207SG0203X | 2011105 | MA | Primary |
Addresses
Primary practice location
65 Landsdowne St
Cambridge, MA 02139-4232
Mailing address
65 Landsdowne St
Cambridge, MA 02139-4232
Phone (617) 768-8292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011105 | MA | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323907200000",
"number": "1629347968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 LANDSDOWNE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394232",
"telephone_number": "617-768-8292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 LANDSDOWNE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394232",
"telephone_number": "617-768-8292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBO",
"first_name": "MATTHEW",
"middle_name": "STEWART",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-15",
"last_updated": "2011-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "MA",
"license": "2011105",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.