Mavis N Matsumoto, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

7825 Issued in NV

Practice address

2780 W Horizon Ridge Pkwy
Suite 30
Henderson, NV 89052-3995

Phone

(702) 992-4050

Fax

(702) 992-4052

NPI assigned

Aug 14, 2006

Last updated

Mar 22, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mavis N Matsumoto MD LLCGroup PAC ID 6800065012, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Las Vegas Home Health Care, Inc Home health agency, Las Vegas, NV, CCN 297168
• Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003

Merit-based Incentive Payment System (MIPS)

Final score

88.98 of 100Reported as apm

Quality

85.1

Promoting interoperability

88.1

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13310/brand/1/csg/1/fhir/r4
• Direct secure messaging: mavis.matsumoto.1@13310.direct.athenahealth.com

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.

• Mavis N Matsumoto, MD, LLC

  • Primary Care Clinic/Center
  • Henderson, NV
  • NPI 1932497229
  Medicare reassignment Care Compare group NPD Authorized official
• Mavis N Matsumoto, MD, LLC

  • Non-Pharmacy Dispensing Site
  • Henderson, NV
  • NPI 1902174741
  NPD (past) Authorized official
• Desert Springs Hospital

  dba Desert Springs Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1154317964
  NPD (past)
• Dignity Health

  dba St. Rose Dominican Hospital, Rose de Lima Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)
• Dignity Health

  dba St. Rose Dominican Hospital, Siena Campus

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Las Vegas Home Health Care, Inc.

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1972786010
  Care Compare affiliation
• Sunrise Hospital and Medical Center, LLC

  dba Sunrise Hospital and Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1861439952
  Care Compare affiliation

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1942213558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530656",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890530656",
            "telephone_number": "702-992-4050",
            "fax_number": "702-992-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 W HORIZON RIDGE PKWY",
            "address_2": "SUITE 30",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523995",
            "telephone_number": "702-992-4050",
            "fax_number": "702-992-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMOTO",
        "first_name": "MAVIS",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "7825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019816",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizebeth Mathew, APRN
• Angelica Esmeralda Mathis
• Mia Matlock
• Aryavanh Matnivong
• Sherise Matson
• M Winston Matsuuchi
• Jose Matta
• Alicia Mattera, CLC
• Sara Frances Matteson, LCMT
• Matthew Geromi, D.O., PC

• Internal Medicine Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.