Individual provider Active NPI

Abhishek Matta, M.B.B.S

  • Critical Care Medicine (Internal Medicine) Physician
  • Lancaster, SC
National Provider Identifier
1760738678
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
46176 Issued in OK
Practice address
800 W Meeting St
Lancaster, SC 29720-2202
Phone
(803) 286-1214
NPI assigned
Jul 28, 2012
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13620 ND
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 46176 OK Primary
Hospitalist Physician 208M00000X 13620 ND
Internal Medicine Physician 207R00000X 6866 NE

Addresses

Primary practice location

800 W Meeting St
Lancaster, SC 29720-2202

Mailing address

PO Box 23321
New York, NY 10087-4321

Other practice location 1

801 Broadway N
Fargo, ND 58102-3641
Phone (701) 234-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, SC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150817001984 ND Practitioner - HospitalistPractitioner - Internal Medicine 5395050546 Reassigns benefits to 1 organization
I20251114000110 SC Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Hospitalist 5395050546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Hospitalist, Internal Medicine, Pulmonary Disease
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

800 W Meeting St
Lancaster, SC 29720-2202
Phone (803) 286-1330

820 W Meeting St
Lancaster, SC 29720-2202
Phone (803) 286-1330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6866NEMDInternal Medicine Physician
46176OKMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Internal Medicine CurrentSince Jul 13, 2015 Accepting new patients
Musc Community Physicians Internal Medicine CurrentSince Oct 13, 2025 Accepting new patients
Musc Community Physicians CurrentSince Oct 13, 2025 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jul 13, 2015 Accepting new patients

Locations

801 Broadway N
Fargo, ND 58102
Phone (701) 234-5121

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

800 W Meeting St
Lancaster, SC 29720
Phone (803) 286-1214

Organizations & group practices 4

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": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1760738678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W MEETING ST",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202202",
            "telephone_number": "803-286-1214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Broadway N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581023641",
            "country_code": "US",
            "telephone_number": "701-234-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTA",
        "first_name": "ABHISHEK",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-28",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "13620",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OK",
            "license": "46176",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ND",
            "license": "13620",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "6866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "800 W Meeting St",
            "city": "Lancaster",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297202202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.