Individual provider Active NPI

Kameron Leigh Matthews, MD, JD

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1902028822
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD045568 Issued in DC
Practice address
546 Eastern Pkwy
Brooklyn, NY 11225-1604
Phone
(000) 000-0000
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036124675 IL
Family Medicine Physician 207Q00000X MD045568 DC Primary

Addresses

Primary practice location

546 Eastern Pkwy
Brooklyn, NY 11225-1604

Mailing address

495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY, NC, OH, MA, IN, FL7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20110302000480 IL Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20220525002316 NY Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20220713000053 NC Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20220913000975 OH Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20230501000811 MA Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20231218001630 IN Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization
I20240521002287 FL Practitioner - Family Practice 0749461317 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045568DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 1, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cityblock Medical Practice, P.a. Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 1, 2014 Accepting new patients
Advantagecare Physicians PC CurrentSince May 1, 2022 Accepting new patients
Advantagecare Physicians PC Family Medicine CurrentSince May 1, 2022 Accepting new patients
Oluwatoyin Ajayi Medical Practice, PC Family Medicine CurrentSince Apr 1, 2023 Accepting new patients
Cityblock Medical Practice, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

15416 N Florida Ave
Ste 203
Tampa, FL 33613
Phone (347) 463-5529

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

55 W Cermak Rd
Chicago, IL 60616
Phone (312) 326-4472

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

2418 W Division St
Chicago, IL 60622
Phone (312) 432-2621

251 E Huron St
Chicago, IL 60611

100 Grove St
Ste 115
Worcester, MA 01605
Phone (347) 463-5529

4444 The Plaza
Charlotte, NC 28215
Phone (336) 360-2407

4444 The Plaza
Unit 18
Charlotte, NC 28215

1439 E Cone Blvd
Greensboro, NC 27405
Phone (336) 375-6104

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676

101 Pennsylvania Ave
Brooklyn, NY 11207
Phone (718) 240-2000

55 Water St
#4C
Brooklyn, NY 11201
Phone (917) 718-2063

495 Flatbush Ave
Brooklyn, NY 11225
Phone 80033611001

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

546 Eastern Pkwy
Brooklyn, NY 11225
Phone (718) 604-4800

800 N High St
Ste 4102
Columbus, OH 43215
Phone (347) 463-5529

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 10

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1902028822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 FLATBUSH AVE STE C5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112253706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112251604",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "KAMERON",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "MD, JD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036124675",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD045568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.