Daisuke Matsuo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R191414 Issued in MD

Practice address

2480 Llewellyn Ave
Fort Meade, MD 20755-7081

Phone

(301) 677-8694

NPI assigned

Jun 22, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1992290951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USAMEDDAC 2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207554031",
            "telephone_number": "301-677-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSUO",
        "first_name": "DAISUKE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R191414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Michael Magyar III, FNP-C
• Peter Makula, D.D.S
• Megan Elizabeth Malis, LCSW
• Gail Lynn Marston, M.D.
• Logan Dishawn Mathus, PTT
• Samantha Beth McCann, DMD
• Stacey Joy Haynes McClintick
• Marnecia McCoy, LICSW, LCSW-C
• Randy Daniel McDonald, CRNA
• Teresa Ann McDowell, LMSW

• Family Nurse Practitioner in Fort Meade, MD
• Providers in Fort Meade, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.