Individual provider Active NPI

Dean M. Matsumae, D.C.

  • Chiropractor
  • Fountain Valley, CA
National Provider Identifier
1942381645
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
20304 Issued in CA
Practice address
17151 Newhope St
Ste111
Fountain Valley, CA 92708-4226
Phone
(714) 424-0099
Fax
(714) 424-0098
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 20304 CA Primary

Addresses

Primary practice location

17151 Newhope St
Ste111
Fountain Valley, CA 92708-4226

Mailing address

17151 Newhope St
Ste111
Fountain Valley, CA 92708-4226
Phone (714) 424-0099

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000407 CA Practitioner - Chiropractic 0648319798 Practice locations: Fountain Valley, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17151 Newhope St
Fountain Valley, CA 92708-4226
Phone (714) 424-0099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20304CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1942381645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17151 NEWHOPE ST",
            "address_2": "STE111",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084226",
            "telephone_number": "714-424-0099",
            "fax_number": "714-424-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17151 NEWHOPE ST",
            "address_2": "STE111",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084226",
            "telephone_number": "714-424-0099",
            "fax_number": "714-424-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUMAE",
        "first_name": "DEAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.