Dr Matthew Gregory Niemi, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Langley Afb, Virginia. His current practice location is
45 Pine St, Langley Afb, Virginia. You can reach out to his office (for appointments etc.) via phone at
(757) 764-9767.
Dr Matthew Gregory Niemi is licensed to practice in Illinois (license number 036176261) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1114904539.
Physician's Profile
| Full Name | Dr Matthew Gregory Niemi |
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| Gender | Male |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 45 Pine St, Langley Afb, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1114904539
- Provider Enumeration Date: 12/28/2005
- Last Update Date: 08/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 7416041850
- Enrollment ID: I20250425001608
Medical Identifiers
Medical identifiers for Dr Matthew Gregory Niemi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114904539 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2085R0202X | Radiology - Diagnostic Radiology | 01054815A (Indiana) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 0101239451 (Virginia) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 036176261 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Matthew Gregory Niemi allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Matthew Gregory Niemi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Matthew Gregory Niemi, MD
9802 River Rd,
Newport News, VA 23601-4211
Ph: (757) 926-4356 | Dr Matthew Gregory Niemi, MD
45 Pine St,
Langley Afb, VA 23665-2025
Ph: (757) 764-9767 |
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