Matrix Medical PLLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

MATRIX MEDICAL PLLC

Practice address

52611 Blueridge Dr
Shelby TWP, MI 48316-2977

Phone

(586) 530-0133

Fax

(586) 262-4158

NPI assigned

Oct 1, 2018

Last updated

Oct 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Cusmano, MD

Title

Executive Director

Phone

(586) 530-0133

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1801371315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52611 BLUERIDGE DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483162977",
            "telephone_number": "586-530-0133",
            "fax_number": "586-262-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52611 BLUERIDGE DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483162977",
            "telephone_number": "586-530-0133",
            "fax_number": "586-262-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "CUSMANO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "586-530-0133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Ann Mansoor, M.D.
• Mark R Sullivan DDS
• James Martin
• Lacey Martinez
• Tracy Marzec, PTA
• Brittany Mattia
• Jessica Marie McCarthy, C.R.N.P.
• McDental Care, P.L.L.C.
• Christine McFarlane, DPT
• Michael David McGough, DPT

• Geriatric Medicine (Internal Medicine) Physician in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Geriatric Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.