MATTHEW J BAK (NPI# 1659386076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659386076 |
| Entity Type | Individual |
| Full Name | MATTHEW J BAK |
| Credential | M.D. |
| Practice Address |
600 Gresham Dr Suite 1100 Norfolk VA 23507-1904 |
| Mailing Address |
Po Box 936 Norfolk VA 23501-0936 |
| Practice Telephone | 7573886200 |
| Practice Fax Number | 7573886201 |
| Mailing Telephone | 7573886200 |
| Mailing Fax Number | 7573886201 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
0101245661 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1659386076 | 05 | |
| VA | VIRGINIA HEALTH NETWORK | PAR | 01 |
| NC | BC/BS | 11764 | 01 |
| VA | ANTHEM BC/BS (FIRST COLONIAL RD.) | 373343 | 01 |
| VA | AETNA | PAR | 01 |
| VA | UNITED HEALTH CARE | PAR | 01 |
| VA | USA MANAGED CARE | PAR | 01 |
| VA | TRICARE/CHAMPUS | -004 | 01 |
| VA | MULTIPLAN | PAR | 01 |
| NC | 5911764 | 05 | |
| VA | CORVEL/CORCARE | PAR | 01 |
| VA | SENTARA OPTIMA HEALTH | 10047408 | 01 |
| VA | ANTHEM BC/BS (GRESHAM DR.) | 373342 | 01 |
| VA | VIRGINIA PREMIER HEALTH | PAR | 01 |
| VA | CIGNA | PAR | 01 |
| VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY | PAR | 01 |
| Street Address |
600 GRESHAM DR SUITE 1100 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900515 | Alan C. Harris | Pathology | 600 Gresham Dr, Sentara Norfolk General Hospital Path Dept, Norfolk, VA 23507-1904 | 2005-05-27 |
| 1144834193 | Ana Rosa Vilela Sangay | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-09-06 |
| 1396357901 | Sentara Reference Lab Solutions, LLC | Clinical Medical Laboratory | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-08-17 |
| 1912515610 | Ashley Conner Hihn | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-19 |
| 1396353181 | Levan Gakhokidze | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-07-17 |
| 1841816022 | Melissa Marie Davis | Nurse Practitioner | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-06-23 |
| 1801417506 | Patricia Dickerson | Respiratory Therapist, Registered | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-05-04 |
| 1871112862 | Larry Michael Newton Jr. | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-10 |
| 1710516000 | Emily Carbaugh | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-07 |
| 1700415254 | Lexie Elizabeth Neubauer | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr, Norfolk, VA 23507-1904 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174968440 | William M Dougherty | Otolaryngology | 600 Gresham Dr Ste 1100, Norfolk, VA 23507-1904 | 2013-05-01 |
| 1760579106 | Ear Nose & Throat Ltd | Otolaryngology | 901 Hampton Blvd, Norfolk, VA 23507-1503 | 2006-10-06 |
| 1316914674 | John T. Sinacori | Otolaryngology | 600 Gresham Dr, Suite 1100, Norfolk, VA 23507-1904 | 2006-03-07 |
| 1760457055 | Daniel W Karakla | Otolaryngology | 600 Gresham Dr, Suite 1100, Norfolk, VA 23507-1904 | 2006-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164946950 | Robert S Schmidt, Md Pllc | Otolaryngology | 1630 Wilkes Ridge Pkwy Ste 104, Richmond, VA 23233-7460 | 2017-08-02 |
| 1952504490 | Mortimer Lee Williams | Otolaryngology | 139 Lee Lane, Irvington, VA 22480 | 2007-06-11 |
| 1629279047 | Travis Laron Shaw | Otolaryngology | 8730 Stony Point Pkwy, Suite 120, Richmond, VA 23235-1970 | 2007-05-31 |
| 1023185394 | Tamer Ghanem | Otolaryngology | Dept. Otolaryngology, University of Virginia, 1 Hospital Dr., 2nd Floor Oms Rm 2747, Charlottesville, VA 22908 | 2006-11-29 |
| 1942384433 | Jeffrey Gardner Neal | Otolaryngology | 176 Valley St W, Abingdon, VA 24210-2836 | 2006-10-24 |
| 1790747889 | Cameron Alexander Gillespie | Otolaryngology | 104 Doctors Park, Galax, VA 24333-2276 | 2006-04-04 |
| 1609843697 | Denton Dean Weiss | Otolaryngology | 272 Bendix Rd, Suite 100, Virginia Beach, VA 23452-1367 | 2006-03-08 |
| 1922091917 | Michael Arthur Alexiou | Otolaryngology | 2062 Pro Pointe Ln, Harrisonburg, VA 22801-8021 | 2005-08-25 |
| 1720259054 | Fairfax Ent & Facial Plastic Surgery, PC | Otolaryngology | 8120 Gatehouse Rd, #3, Falls Church, VA 22042-1204 | 2008-03-14 |
| 1154398378 | Antonio J. Cachay | Otolaryngology | 3289 Woodburn Rd, Suite 85, Annandale, VA 22003-6800 | 2006-03-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.