Individual provider Active NPI

Mark Matus, MD

  • Student in an Organized Health Care Education/Training Program
  • Chattanooga, TN
National Provider Identifier
1780388165
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1100 E 3Rd St
Chattanooga, TN 37403-2241
Phone
(423) 778-2957
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1100 E 3Rd St
Chattanooga, TN 37403-2241

Mailing address

1100 E 3Rd St
Chattanooga, TN 37403-2241
Phone (423) 778-2957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20251219002441 NY Practitioner - Internal Medicine 8123560307 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peyman Younesi MD PLLCGroup PAC ID 4981860202, 98 clinicians

Practice addresses (Care Compare)

612 Allerton Ave
Bronx, NY 10467-7404
Phone (718) 709-0940

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Meadows Physician Practice PLLC CurrentSince Jan 1, 2026 Accepting new patients
Peyman Younesi MD PLLC CurrentSince Nov 1, 2025 Accepting new patients
Medm LLC PastSince May 1, 2024 Accepting new patients

Locations

147 2nd Ave
Brentwood, NY 11717
Phone (631) 273-7204

612 Allerton Ave
Bronx, NY 10467
Phone (718) 519-4125

2830 Pitkin Ave
Brooklyn, NY 11208
Phone (347) 420-8295

8008 45th Ave
Flushing, NY 11373
Phone (718) 373-0777

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

822 Cedar Ave
Niagara Falls, NY 14301
Phone (716) 272-1207

Organizations & group practices 3

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1780388165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032241",
            "telephone_number": "423-778-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032241",
            "telephone_number": "423-778-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.