Kojiro Matsumoto, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125-057080 Issued in IL

Practice address

1436 Deerfield Rd
Deerfield, IL 60015-2758

Phone

(312) 731-0331

NPI assigned

Jul 10, 2009

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 IL

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

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nihon Medical Clinic, S.C.Group PAC ID 2567623002, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Nihon Medical Clinic, S.C.

  • Ph.D. Medical Genetics
  • Arlington Heights, IL
  • NPI 1548532526
  Medicare reassignment Care Compare group NPD
• Medreat

  • Clinic/Center
  • Deerfield, IL
  • NPI 1487262192
  NPD Authorized official

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1780813840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 DEERFIELD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152758",
            "telephone_number": "312-731-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 DEERFIELD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152758",
            "telephone_number": "312-731-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025238",
            "country_code": "US",
            "telephone_number": "217-757-8100",
            "fax_number": "217-747-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "KOJIRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125-057080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Marsh, LCSW
• Janet Martig, PHARM.D.
• Evelyn Martinez
• Mary E Halpin PHD PC
• Mary Mika, Psy.D. PLLC
• Kathryn Christina Matthews
• Michael D Matthews, OD
• Ronald Charles May, M.D.
• Douglas Aloysius Mazewski, PHARMD
• Amy Lyn McAndrew, PTA

• Family Medicine Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.