Individual provider Active NPI

Matthew Steven Macdougall, MD, PHD

  • Pediatrics Physician
  • Palo Alto, CA
National Provider Identifier
1740867001
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A195055 Issued in CA
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 497-8000
NPI assigned
Mar 24, 2021
Last updated
Dec 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A195055 CA
Pediatrics Physician 208000000X A195055 CA Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

269 Campus Drive
CCSR Suite 3215, Division of Allergy & Immunology
Palo Alto, CA 94304-1601
Phone (650) 497-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250210001821 CA Practitioner - Pediatric Medicine 0749710572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195055CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Pediatrics Current Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jan 30, 2025 Accepting new patients
County of Santa Clara CurrentSince Jan 30, 2025 Accepting new patients
Stanford Health Care Pediatrics PastSince Dec 22, 2024 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: mmacdougall175890@santaclaravalley.direct-ci.net

Organizations & group practices 5

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1740867001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 CAMPUS DRIVE",
            "address_2": "CCSR SUITE 3215, DIVISION OF ALLERGY & IMMUNOLOGY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000",
            "fax_number": "650-497-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDOUGALL",
        "first_name": "MATTHEW",
        "middle_name": "STEVEN",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A195055",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A195055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.