Individual provider Active NPI

Jeffrey Scott Matoshko, DC

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1689781023
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
JM005363 Issued in MI
Practice address
5754 15 Mile Rd
Sterling Heights, MI 48310-5777
Phone
(586) 795-8989
Fax
(586) 999-5989
NPI assigned
Aug 23, 2006
Last updated
Apr 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X JM005363 MI Primary

Addresses

Primary practice location

5754 15 Mile Rd
Sterling Heights, MI 48310-5777

Mailing address

5754 15 Mile Rd
Sterling Heights, MI 48310-5777
Phone (586) 795-8989

Other identifiers 1

IdentifierTypeStateIssuer
4754035MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040927000369 MI Practitioner - Chiropractic 2466431267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5754 15 Mile Rd
Sterling Heights, MI 48310-5777
Phone (586) 795-8989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JM005363MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Matoshko Chiropractic Clinic LLC Chiropractor CurrentSince Jan 13, 2022 Accepting new patients
Butzin, Matoshko & Associates Chiropractor CurrentSince Jan 21, 2002 Accepting new patients
Butzin Chiropractic Clinic LLC Chiropractor PastSince Oct 17, 2021 Accepting new patients
William F Goss DC I PLLC Chiropractor PastSince Jul 20, 2016 Accepting new patients

Locations

2050 Chesley Dr
Ste 2
Sterling Heights, MI 48310
Phone (586) 268-8882

2050 Chesley Dr
Sterling Hts, MI 48310
Phone (586) 268-8882

5754 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 795-8989

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1689781023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5754 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105777",
            "telephone_number": "586-795-8989",
            "fax_number": "586-999-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5754 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105777",
            "telephone_number": "586-795-8989",
            "fax_number": "586-999-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOSHKO",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "JM005363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4754035",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.