Individual provider Active NPI

Matthew J. Gwiazdon, MD

  • Internal Medicine Physician
  • Plymouth, MA
National Provider Identifier
1851920110
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12439648-1205 Issued in UT
Practice address
110 Long Pond Rd Ste 104
Plymouth, MA 02360-2642
Phone
(508) 746-6096
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12439648-1205 UT Primary

Addresses

Primary practice location

110 Long Pond Rd Ste 104
Plymouth, MA 02360-2642

Mailing address

275 Sandwich St
Plymouth, MA 02360-2183
Phone (508) 830-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250708003922 MA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4688070477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Nevada School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Sep 1, 2025 Accepting new patients

Locations

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

110 Long Pond Rd
Ste 104
Plymouth, MA 02360
Phone (508) 746-6096

46 Obery St
Ste 100
Plymouth, MA 02360
Phone (508) 746-0284

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1851920110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-830-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 104",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-746-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIAZDON",
        "first_name": "MATTHEW",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "12439648-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.