Matthew Custodio

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD489166 Issued in PA

Practice address

333 Cottman Ave
Philadelphia, PA 19111-2434

Phone

(215) 214-1424

Fax

(215) 214-1425

NPI assigned

Mar 18, 2019

Last updated

Feb 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Gastroenterology

Education

State University of New York Downstate Medical Center, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mcustodio117760@direct.bmc.masshiway.net

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.

• Temple Faculty Practice Plan Inc

  dba Temple Faculty Anesthesiology Associates

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Temple Faculty Practice Plan Inc

  dba Temple Faculty Dermatology Associates

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1285116228
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Oncologic Hospital

  • Special Hospital
  • Philadelphia, PA
  • NPI 1730195017
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1770042988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-214-1424",
            "fax_number": "215-214-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD489166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert E Cushing III, M.D.
• Katherine Cushing, D.M.D.
• Brittany Custer, DO
• Yang Chang Custer, MS, MPHIL, LPC
• Manuel Custodio, MA
• Keith Custus
• Dawn Cute, D.C.
• Emily Rose Cuthbertson, M.D.
• Cutie Pie Therapy LLC
• Joseph Cutillo Jr.

• Gastroenterology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gastroenterology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.