Active NPI
Matthew Robert Zetumer, M.D.
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1952332983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A31554
- Practice address
- 5190 Governor Dr. #102
San Diego, CA 92122-2846 - Phone
- (858) 452-9969
- Fax
- (858) 452-5729
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A31554 | CA | Primary |
Addresses
Primary practice location
5190 Governor Dr. #102
San Diego, CA 92122-2846
Mailing address
5190 Governor Dr. #102
San Diego, CA 92122-2846
Phone (858) 452-9969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 4, 2015 through Dec 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31554 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952332983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5190 GOVERNOR DR. #102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921222846",
"telephone_number": "858-452-9969",
"fax_number": "858-452-5729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5190 GOVERNOR DR. #102",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921222846",
"telephone_number": "858-452-9969",
"fax_number": "858-452-5729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZETUMER",
"first_name": "MATTHEW",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A31554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.