Individual provider Active NPI

Matthew A Jeffreys, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Fayetteville, AR
National Provider Identifier
1790103521
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E-11231 Issued in AR
Practice address
390 E Longview St
Fayetteville, AR 72703-4618
Phone
(479) 442-0144
NPI assigned
Mar 29, 2014
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-11231 AR Primary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 38609 OK

Addresses

Primary practice location

390 E Longview St
Fayetteville, AR 72703-4618

Mailing address

390 E Longview St
Fayetteville, AR 72703-4618
Phone (479) 442-0144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 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
I20180626001219 AR Practitioner - Pathology 7911222666 Reassigns benefits to 4 organizations
I20220820000020 TX Practitioner - Pathology 7911222666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

1001 S 41St St E
Three Rivers Health Center
Muskogee, OK 74403-6253
Phone (918) 687-0201

390 E Longview St
Fayetteville, AR 72703-4618
Phone (479) 442-0144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38609OKMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jun 28, 2022 Accepting new patients
University of Arkansas for Medical Sciences Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
University of Arkansas for Medical Sciences Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
University of Arkansas for Medical Sciences Single Specialty Current Accepting new patients
University of Arkansas for Medical Sciences Single Specialty CurrentSince Jan 8, 2019 Accepting new patients
Arkansas Children's Hospital CurrentSince Jan 8, 2019 Accepting new patients
Cherokee Nation Single Specialty CurrentSince Jun 28, 2022 Accepting new patients
University of Arkansas for Medical Sciences Single Specialty Current Accepting new patients
Arkansas Childrens Hospital Single Specialty CurrentSince Jan 8, 2019 Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients
Cherokee Nation Single Specialty Current Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • Direct secure messaging: mjeffreys21288@washingtonregional.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1790103521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E LONGVIEW ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034618",
            "telephone_number": "479-442-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E LONGVIEW ST",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034618",
            "telephone_number": "479-442-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFREYS",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-29",
        "last_updated": "2022-10-24",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-11231",
            "primary": true
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "OK",
            "license": "38609",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.