NPIMap

Individual provider Active NPI

Kimberly Ann Matzie, MD

  • Colon & Rectal Surgery Physician
  • Fairfax, VA
National Provider Identifier
1861579898
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
0101248220 Issued in VA
Practice address
2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone
(703) 280-2841
Fax
(703) 280-4773
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 0101248220 VA Primary
Surgery Physician 208600000X 224443 MA

Addresses

Primary practice location

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357

Mailing address

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4357
Phone (703) 280-2841

Other identifiers 1

IdentifierTypeStateIssuer
1861579898MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110119000557 DC Practitioner - Colorectal Surgery (Proctology) 8022297357 Reassigns benefits to 2 organizations
I20151215002110 VA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8022297357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Perelman School of Med at the University of Pennsylvania, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairfax Colon and Rectal Surgery PCGroup PAC ID 4385628411, 12 clinicians

Practice addresses (Care Compare)

2710 Prosperity Ave
Suite 200
Fairfax, VA 22031-4358
Phone (703) 280-2841

44045 Riverside Pkwy
Suite 102
Lansdowne, VA 20176-5101
Phone (703) 280-2841

7051 Heathcote Village Way
Suite 135
Gainesville, VA 20155-3196
Phone (703) 280-2841

Hospital & facility affiliations

  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224443MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services Current Accepting new patients
Fairfax Colon & Rectal Surgery Center, LLC Colon & Rectal Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1800 N Beauregard St
Ste 310
Alexandria, VA 22311

3700 Joseph Siewick Dr
Ste 202
Fairfax, VA 22033
Phone (703) 620-1770

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44055 Riverside Pkwy
Ste 102
Leesburg, VA 20176
Phone (703) 858-1500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAEJBD
  • Direct secure messaging: kimberly.matzie@fcrs.eclinicaldirectplus.com

Organizations & group practices 5

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 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1861579898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841",
            "fax_number": "703-280-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "703-280-2841",
            "fax_number": "703-280-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZIE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "VA",
            "license": "0101248220",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "224443",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861579898",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.