Ambar Matta, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

58734 Issued in AZ

Practice address

2945 S Dobson Rd
Mesa, AZ 85202-7941

Phone

(480) 969-4138

Fax

(480) 969-0630

NPI assigned

Jun 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, AZ, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

General Surgery

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122
• Banner Ocotillo Medical Center Hospital, Chandler, AZ, CCN 030147

Merit-based Incentive Payment System (MIPS)

Final score

94.9 of 100Reported as group

Promoting interoperability

94

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amatta119723@direct.rivhs.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IGJBCD

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment Care Compare group NPD
• Arizona Advanced Surgery LLC

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1346880838
  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• DHP of Virginia PC

  • Hospitalist Physician
  • Leesburg, VA
  • NPI 1992060255
  Medicare reassignment NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061
  Medicare reassignment NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623
  NPD

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

• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Health

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1972139004
  Care Compare affiliation

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1730474115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041303",
            "telephone_number": "602-258-9900",
            "fax_number": "602-258-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027941",
            "telephone_number": "480-969-4138",
            "fax_number": "480-969-0630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3620 Joseph Siewick Dr",
            "address_2": "Suite 406",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331756",
            "country_code": "US",
            "telephone_number": "703-359-8640",
            "fax_number": "703-591-6105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20486 Market Street",
            "address_purpose": "LOCATION",
            "city": "Onancock",
            "state": "VA",
            "postal_code": "23417",
            "country_code": "US",
            "telephone_number": "757-302-2700",
            "fax_number": "757-787-9262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTA",
        "first_name": "AMBAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101258628",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "57.015725",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "58734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl S Mathis, LCSW, LSCSW
• Kimberly Marie Mathis, L.AC.
• Sumir Prasad Mathur
• Sean Cayabyab Matienzo, PHARM D.
• Matrix Integrated Anesthesia LLC
• Ellen L Matta, CRNA
• Douglas Robert Matter, RPH
• Mark J. Mattern, M.D.
• Andre Charles Matthews, M.D.
• Brianna Mary Matthews, DO

• Surgery Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.