NPIMap

Individual provider Active NPI

Matthew Deneke, MD

  • Gastroenterology Physician
  • Little Rock, AR
National Provider Identifier
1689764151
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
56852 Issued in MN
Practice address
4301 W Markham St # 783
Little Rock, AR 72205
Phone
(501) 686-8000
Fax
(501) 526-4596
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 107008 MN
Gastroenterology Physician 207RG0100X 56852 MN Primary
Internal Medicine Physician 207R00000X E-4436 AR

Addresses

Primary practice location

4301 W Markham St # 783
Little Rock, AR 72205

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7199
Phone (501) 686-8000

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 4

IdentifierTypeStateIssuer
157947001MedicaidAR
05060013900OtherARQUALCHOICE
5N259OtherARBCBS
P00295353OtherARRAILROAD MEDICARE1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050809000911 AR Practitioner - GastroenterologyPractitioner - Internal Medicine 1254360365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

4301 W Markam St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Hospital & facility affiliations

  • University of Arkansas Medical Sciences Hospital, Little Rock, AR, CCN 040016
  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy19
Upper gastrointestinal (GI) endoscopy for acid reflux31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107008MNMDGastroenterology Physician
56852MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2005 Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Ste 783
Little Rock, AR 72205
Phone (501) 603-1278

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1689764151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-4596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENEKE",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "107008",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "56852",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-4436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157947001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "05060013900",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5N259",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE1",
            "identifier": "P00295353",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.