Matthew Root DO Inc

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

MATTHEW ROOT DO INC

Doing business as

Innovative Pain and Spine Center

Practice address

13320 Riverside Dr Ste 214
Sherman Oaks, CA 91423-2512

Phone

(818) 621-0019

Fax

(818) 671-5556

NPI assigned

Aug 30, 2018

Last updated

Nov 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew S Root, D.O.NPI 1043593098

Title

Owner

Phone

(818) 621-0019

Specialties & licenses 2

Addresses

Other names 1

• Innovative Pain and Spine Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Matthew Root DO Inc

  • Ambulatory Surgical Clinic/Center
  • Sherman Oaks, CA
  • NPI 1417877275
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew S Root, DO

  • Interventional Pain Medicine Physician
  • Sherman Oaks, CA
  • NPI 1043593098
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1760964340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13320 RIVERSIDE DR STE 214",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232512",
            "telephone_number": "818-621-0019",
            "fax_number": "818-671-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13320 RIVERSIDE DR STE 214",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232512",
            "telephone_number": "818-621-0019",
            "fax_number": "818-671-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW ROOT DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "ROOT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-621-0019",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Pain and Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexander Carlos Matos Wong, DDS
• Shannon Kay Matricaria, MSW
• Jennifer Matsumura, LCSW
• Michael Alan Mattes, DPM, PHARM.D.
• Matthew Root DO Inc
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• Max Maisel PHD, a Psychological Corporation
• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.
• Maxim Healthcare Services, Inc.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.