NPIMap

Individual provider Active NPI

Frederick L Matti, M.D.

  • Diagnostic Radiology Physician
  • Rock Springs, WY
National Provider Identifier
1881652204
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
7199A Issued in WY
Practice address
1200 College Dr
Rock Springs, WY 82901-5868
Phone
(786) 621-3900
Fax
(307) 875-8800
NPI assigned
May 3, 2006
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7199A WY Primary

Addresses

Primary practice location

1200 College Dr
Rock Springs, WY 82901-5868

Mailing address

2780 Hitching Post Dr
Green River, WY 82935-6155
Phone (786) 621-3900

Other identifiers 1

IdentifierTypeStateIssuer
120672900MedicaidWY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050221000212 WY Practitioner - Diagnostic Radiology 1759351133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of South Florida College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical Imaging LLCGroup PAC ID 9436159415, 3 clinicians

Practice addresses (Care Compare)

1200 College Dr
Rock Springs, WY 82901-5868
Phone (786) 621-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
76.2
Improvement activities
40
Cost
74.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7199AWYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetwater Radiology, PC Diagnostic Radiology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1881652204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 HITCHING POST DR",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356155",
            "telephone_number": "786-621-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015868",
            "telephone_number": "786-621-3900",
            "fax_number": "307-875-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTI",
        "first_name": "FREDERICK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "7199A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120672900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

Verify at the official NPI Registry.