NPIMap

Individual provider Active NPI

Sarah Ann S Matouk, D.P.M.

  • Podiatrist
  • Los Banos, CA
National Provider Identifier
1992144430
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5467 Issued in CA
Practice address
400 W I St Ste C
Los Banos, CA 93635-3459
Phone
(209) 827-2766
NPI assigned
Jun 18, 2013
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5467 CA Primary
Podiatrist 213E00000X 135000807 IL

Addresses

Primary practice location

400 W I St Ste C
Los Banos, CA 93635-3459

Mailing address

311 W I St
Los Banos, CA 93635-3479
Phone (708) 341-6428

Other practice location 1

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-2222

Other practice location 2

400 W I St Ste A
Los Banos, CA 93635-3459
Phone (209) 827-9999

Other practice location 3

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620002319 CA Practitioner - Podiatry 4385868926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KD Medical Group IncGroup PAC ID 2860553468, 6 clinicians

Practice addresses (Care Compare)

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-6444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.4 of 100Reported as group
Quality
100
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue67
Removal of skin lesions1-10
Removal of nail tissue940
Removal or shaving of skin growth411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5467CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
KD Medical Group Inc Podiatrist CurrentSince Jun 4, 2018 Accepting new patients
KD Medical Group Inc CurrentSince Jun 4, 2018 Accepting new patients
Relieve Physical Therapy & Wellness CurrentSince Jul 22, 2016 Accepting new patients
Memorail Hospital of Los Banos Past Accepting new patients
Apex Annex Health Center,Inc Past Accepting new patients
Adventist Bolingbrook Hospital Past Accepting new patients
Dos Palos Apex Health Center Inc Past Accepting new patients
Emergency Foot Care LLC Podiatrist Past Accepting new patients

Locations

311 W I St
Los Banos, CA 93635
Phone (209) 826-2222

311 W I St
#B
Los Banos, CA 93635
Phone (209) 826-2222

311 W I St
Ste A
Los Banos, CA 93635

400 W I St
Ste C
Los Banos, CA 93635
Phone (209) 710-6333

14236 McCarthy Rd
Lemont, IL 60439
Phone (630) 863-7517

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sarah.ann.matouk.1@3550.direct.athenahealth.com
  • Direct secure messaging: sarah.matouk.1@3550.direct.athenahealth.com
  • Direct secure messaging: smatouk@direct.ccprovider.org

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1992144430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "708-341-6428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W I ST STE C",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353459",
            "telephone_number": "209-827-2766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 W I St",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353479",
            "country_code": "US",
            "telephone_number": "209-826-2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W I St Ste A",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353459",
            "country_code": "US",
            "telephone_number": "209-827-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 W I St",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353479",
            "country_code": "US",
            "telephone_number": "209-826-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATOUK",
        "first_name": "SARAH ANN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "5467",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "135000807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.