Individual provider Active NPI

Matthew James Makaroff

  • Basic Emergency Medical Technician
  • Fresno, CA
National Provider Identifier
1699412692
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
B10-8697 Issued in CA
Practice address
2960 S Cherry Ave
Fresno, CA 93706-5445
Phone
(800) 255-7227
NPI assigned
May 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X B10-8697 CA Primary

Addresses

Primary practice location

2960 S Cherry Ave
Fresno, CA 93706-5445

Mailing address

2960 S Cherry Ave
Fresno, CA 93706-5445

Other identifiers 1

IdentifierTypeStateIssuer
B10-8697OtherCAEMT

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

State licenses

LicenseStateTypeSpecialty
B10-8697CAMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1699412692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 S CHERRY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 S CHERRY AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937065445",
            "telephone_number": "800-255-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKAROFF",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "B10-8697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMT",
            "identifier": "B10-8697",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.