Individual provider Active NPI

Matthew Gordon Boliaux, DO

  • Sleep Medicine (Internal Medicine) Physician
  • Phoenix, AZ
National Provider Identifier
1811638851
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
012497 Issued in AZ
Practice address
2910 N 3Rd Ave Ste 470
Phoenix, AZ 85013-4434
Phone
(602) 406-6262
Fax
(602) 406-6261
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 012497 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X AZ

Addresses

Primary practice location

2910 N 3Rd Ave Ste 470
Phoenix, AZ 85013-4434

Mailing address

240 W Thomas Rd # 301
Phoenix, AZ 85013-4407
Phone (602) 406-6262

Other practice location 1

755 E McDowell Rd
Phoenix, AZ 85006-2506
Phone (480) 412-3684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220630001966 AZ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2062892516

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sjhmc Physician Services Past Accepting new patients

Organizations & group practices 1

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1811638851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W THOMAS RD # 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134407",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 N 3RD AVE STE 470",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134434",
            "telephone_number": "602-406-6262",
            "fax_number": "602-406-6261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "755 E McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062506",
            "country_code": "US",
            "telephone_number": "480-412-3684",
            "fax_number": "602-839-4233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLIAUX",
        "first_name": "MATTHEW",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "AZ",
            "license": "012497",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.