Individual provider Active NPI

Matthew Tamplen, M.D.

  • Otolaryngology Physician
  • Orinda, CA
National Provider Identifier
1801148242
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
64664 Issued in AZ
Practice address
77 Moraga Way Ste G
Orinda, CA 94563-3019
Phone
(925) 444-0824
NPI assigned
Oct 9, 2012
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME130782 FL
Otolaryngology Physician 207Y00000X 64664 AZ Primary
Facial Plastic Surgery Physician 207YS0123X 64664 AZ

Addresses

Primary practice location

77 Moraga Way Ste G
Orinda, CA 94563-3019

Mailing address

4530 E Shea Blvd Ste 180
Phoenix, AZ 85028-6042
Phone (602) 264-4834

Other identifiers 2

IdentifierTypeStateIssuer
021413300MedicaidFL
YD6TCOtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 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
I20190218002369 CA Practitioner - Otolaryngology 7719270339 Reassigns benefits to 2 organizations
I20220222001175 AZ Practitioner - Otolaryngology 7719270339 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME130782FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Orthopaedic Surgery Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 29, 2018 Accepting new patients
Arizona Otolaryngology Consultants, PC CurrentSince Feb 1, 2022 Accepting new patients
Permanente Medical Group Inc Orthopaedic Surgery CurrentSince Oct 29, 2018 Accepting new patients
Sigma Ear Nose & Throat Otolaryngology CurrentSince Oct 20, 2021 Accepting new patients
Romeo C. Agbayani Jr MD a Professional Medical Corporation PastSince Jun 26, 2021 Accepting new patients

Locations

5750 W Thunderbird Rd
Ste A100
Glendale, AZ 85306
Phone (602) 938-3205

4530 E Shea Blvd
Ste 180
Phoenix, AZ 85028
Phone (602) 264-4834

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

3600 Broadway
Oakland, CA 94611
Phone (510) 752-6238

77 Moraga Way
Ste G
Orinda, CA 94563
Phone (833) 880-7433

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1700 San Pablo Ave
Ste F
Pinole, CA 94564
Phone (510) 483-3565

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1801148242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E SHEA BLVD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286042",
            "telephone_number": "602-264-4834",
            "fax_number": "602-254-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MORAGA WAY STE G",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633019",
            "telephone_number": "925-444-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMPLEN",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-09",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME130782",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "64664",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "64664",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021413300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "YD6TC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

Verify at the official NPI Registry.