Matin Nekzad, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036098147 Issued in IL

Practice address

1006 S Division St
Carterville, IL 62918-1539

Phone

(618) 985-4841

Fax

(618) 985-4535

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Health Service and Development CorpGroup PAC ID 1658285671, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• LHC-Illinois Home Health Care Home health agency, Marion, IL, CCN 147716
• Residential Home Health of Southern Illinois, LLC Home health agency, Marion, IL, CCN 147112
• Hospice of Southern Illinois, Inc Hospice, Belleville, IL, CCN 141504
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matin.nekzad.1@14668.direct.athenahealth.com

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.

• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1639295314

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Shawnee Health Service and Development Corp

  • Community/Retail Pharmacy
  • Carbondale, IL
  • NPI 1760253447
  NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1811928732

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Regional Healthcare Services Illinois Inc

  • General Acute Care Hospital
  • Marion, IL
  • NPI 1750007266
  Care Compare affiliation
• Hospice of Southern Illinois, Inc.

  • Community Based Hospice Care Agency
  • Belleville, IL
  • NPI 1720081805
  Care Compare affiliation
• LHCG Xxxvii, LLC

  • Home Health Agency
  • Marion, IL
  • NPI 1740527407
  Care Compare affiliation
• Residential Home Health of Southern Illinois, LLC

  • Home Health Agency
  • Marion, IL
  • NPI 1235556838
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1679548689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-985-8221",
            "fax_number": "618-985-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S DIVISION ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181539",
            "telephone_number": "618-985-4841",
            "fax_number": "618-985-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEKZAD",
        "first_name": "MATIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "IL",
            "license": "036.098147",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CF3444",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370966854004",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matin.nekzad.1@14668.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1006 S Division St",
            "city": "Carterville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629181539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matin.nekzad.1@14668.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1006 S Division St",
            "city": "Carterville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629181539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jill Elizabeth Morthland, MSW
• Linda Muckey
• Mary C Murray, LCP
• National Imaging of Carterville LLC
• Shantell Neal
• Angie Nessa
• Debra Newbolds
• Rebecca Newburn
• Abigail Nketia
• Northland Hearing Centers, Inc.

• Family Medicine Physician in Carterville, IL
• Providers in Carterville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.