Matthew Edinger, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102207395 Issued in VA

Practice address

U.S. Naval Hospital Guam
BLDG 50 Agana H
Agana Heights, GU 96910

Phone

(671) 484-2445

NPI assigned

Mar 24, 2021

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Enrolled in VA

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2024.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1740867142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 455 BOX 208",
            "city": "FPO",
            "state": "AP",
            "postal_code": "965400003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U.S. NAVAL HOSPITAL GUAM",
            "address_2": "BLDG 50 AGANA H",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-484-2445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Child St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322145005",
            "country_code": "US",
            "telephone_number": "904-542-7762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDINGER",
        "first_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102207395",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Gus Demitrack Jr., M.D.
• Nelson Desouza, MD
• Taylor Desrosiers, MD, MBA
• Taylor Dickinson, CRNA
• Maryann Lumba Dizon, RN
• Erica Dawn T Escalante, LCSW
• Bryan Mason Faulk, DENTAL TECHNICIAN
• Shirae Antoinette Cepeda Fejeran, RN
• Kathleen Mae Cajigal Fernandez, RN
• Jamie Lynn Fitch, M.D.

• All providers in Agana Heights, GU
• Family Medicine Physician in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.