Basic Information
| Provider Information | |||||||||
| NPI: | 1316956675 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HJORT | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 01/08/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 216100 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | 216100 | MA | N | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | MULTI-PLAN | OTHER | 0653171 | 01 | CIGNA | OTHER | 042297845 | 01 | TRICARE | OTHER | 1316956675 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | 042297845 | 01 | MA | UNITED HEALTH CARE | OTHER | 1316956675 | 01 | FALLON | OTHER | 7758399 | 01 | AETNA | OTHER | 110006720A | 05 | MA | MEDICAID | 216100 | 01 | HCVM/FIRST HEALTH/COVENTRY | OTHER | AA162621 | 01 | HARVARD PILGRIM | OTHER | 042297845 | 01 | GIC/UNICARE | OTHER | 216100 | 01 | TUFTS | OTHER | J25498 | 01 | MA | BCBSMA | OTHER |