Individual provider Active NPI

Matthew Salah Masry, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Wright Patterson Afb, OH
National Provider Identifier
1912966300
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
233205 Issued in NY
Practice address
88TH Medical Group
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433
Phone
(937) 713-4482
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 233205 NY Primary

Addresses

Primary practice location

88TH Medical Group
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433

Mailing address

88TH Medical Group
4881 Sugar Maple Dr
Wright Patterson, OH 45433-2259
Phone (937) 713-4482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120802000599 MS Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9335136100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Med Care Inc. Past Accepting new patients
Bon Secours Community Hospital 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1912966300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88TH MEDICAL GROUP",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON",
            "state": "OH",
            "postal_code": "454332259",
            "telephone_number": "937-713-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88TH MEDICAL GROUP",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-713-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASRY",
        "first_name": "MATTHEW",
        "middle_name": "SALAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2021-08-04",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "233205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.