Organization Active NPI

Belen Matias, MD a Medical Corp

  • Infectious Disease Physician
  • Northridge, CA
National Provider Identifier
1881706190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A056439 Issued in CA
Legal business name
BELEN MATIAS, MD A MEDICAL CORP
Practice address
17075 Devonshire St
Suite 305
Northridge, CA 91325-1600
Phone
(818) 363-0110
Fax
(818) 363-0160
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Annpaula Bandayrel
Title
Office Manager
Phone
(818) 363-0110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X A056439 CA Primary

Addresses

Primary practice location

17075 Devonshire St
Suite 305
Northridge, CA 91325-1600

Mailing address

17075 Devonshire St
Suite 305
Northridge, CA 91325-1600
Phone (818) 363-0110

Other identifiers 1

IdentifierTypeStateIssuer
00A564390MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110405000169 CA Part B Supplier - Clinic/Group Practice 4082898705 Receives reassigned benefits from 1 practitioner
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881706190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 305",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-363-0110",
            "fax_number": "818-363-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 DEVONSHIRE ST",
            "address_2": "SUITE 305",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913251600",
            "telephone_number": "818-363-0110",
            "fax_number": "818-363-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELEN MATIAS, MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANDAYREL",
        "authorized_official_first_name": "ANNPAULA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "818-363-0110"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A056439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A564390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.