Individual provider Active NPI

Matthew Patrick Hoffman, DC

  • Chiropractor
  • Bourbonnais, IL
National Provider Identifier
1679762504
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007367 Issued in IL
Practice address
662 N Convent St
Bourbonnais, IL 60914-1329
Phone
(815) 937-0446
Fax
(815) 937-0487
NPI assigned
Oct 16, 2007
Last updated
Mar 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038007367 IL Primary

Addresses

Primary practice location

662 N Convent St
Bourbonnais, IL 60914-1329

Mailing address

662 N Convent St
Bourbonnais, IL 60914-1329
Phone (815) 937-0446

Other identifiers 1

IdentifierTypeStateIssuer
04622727OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060302000581 IL Practitioner - Chiropractic 9335155191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

588 William Latham Dr
Suite 5
Bourbonnais, IL 60914-2340
Phone (815) 937-0446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1679762504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141329",
            "telephone_number": "815-937-0446",
            "fax_number": "815-937-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 N CONVENT ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141329",
            "telephone_number": "815-937-0446",
            "fax_number": "815-937-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MATTHEW",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04622727",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.