Matthew Ryan Michienzi, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0102208361 Issued in VA

Practice address

Walter Reed National Military Medical Center
8901 Rockville Pike
Bethesda, MD 20889

Phone

(301) 295-4000

NPI assigned

Mar 11, 2022

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1699423459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20889",
            "telephone_number": "301-295-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "address_2": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20889",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHIENZI",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-11",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102208361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Nicholas.a.lawson5.civ@health.mil",
            "affiliation": "N",
            "address_1": "Brooke Army Medical Center Pediatrics",
            "address_2": "3551 Roger Brooke Dr.",
            "city": "JBSA-Fort Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "elizabeth.saucedo.civ@mail.mil",
            "affiliation": "N",
            "address_1": "Brooke Army Medical Center Pediatric Residency",
            "address_2": "3551 Roger Brooke Dr.",
            "city": "JBSA-Fort Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rachel.antzak.ctr@usuhs.edu",
            "affiliation": "N",
            "address_1": "Walter Reed National Military Medical Center",
            "address_2": "8901 Rockville Pike",
            "city": "Bethesda",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatrics Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.