Individual provider Active NPI

Gerard A Matysik, DO

  • Pulmonary Disease Physician
  • Pella, IA
National Provider Identifier
1750367124
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
OS11802 Issued in FL
Practice address
405 Monroe St
Pella, IA 50219-1189
Phone
(641) 621-2200
Fax
(641) 621-2335
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X OS11802 FL Primary

Addresses

Primary practice location

405 Monroe St
Pella, IA 50219-1189

Mailing address

405 Monroe St
Pella, IA 50219-1189
Phone (641) 621-2200

Other identifiers 2

IdentifierTypeStateIssuer
560910040OtherIAMEDICARE PTAN NUMBER
1750367124OtherNPI NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prhc@direct.pellahealth.kobledirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.84 of 100Reported as group
Quality
91.13
Promoting interoperability
100
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pella Regional Health Center Current Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients

Locations

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1750367124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-621-2200",
            "fax_number": "641-621-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-621-2200",
            "fax_number": "641-621-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYSIK",
        "first_name": "GERARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS11802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN NUMBER",
            "identifier": "560910040",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1750367124",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prhc@direct.pellahealth.kobledirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "405 Monroe St",
            "city": "Pella",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502191189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.