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DR. MATTHEW LICERALDE ELLOSO M.D.
NPI 1447563150
Internal Medicine in Grand Rapids, MI

Active since July 22, 2010
100 MICHIGAN ST NE, SUITE A721, GRAND RAPIDS, MI 49503(616) 391-3139(616) 391-3044 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 28, 2021, Mar 5, 2021 (2 updates tracked since 2021).

About Dr. Matthew Liceralde Elloso M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MATTHEW LICERALDE ELLOSO M.D. (NPI 1447563150) is an individual internal medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301096516) and active in the NPI registry since July 2010.

NPPES Registry Identity

NPI1447563150
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MATTHEW LICERALDE ELLOSOCredential: M.D.
Location Address100 MICHIGAN ST NE, SUITE A721Grand Rapids, MI 49503-2560
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 391-3139
Fax(616) 391-3044
Sole ProprietorNo
Enumeration DateJuly 22, 2010
Last NPPES UpdateJune 28, 20212 updates tracked since enumeration
NPPES CertifiedJune 28, 2021
✔ NPI 1447563150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301096516
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
100 MICHIGAN ST NE, Grand Rapids, MI 49503
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAUREEN TAN PEDRES M.D.
Internal Medicine
100 MICHIGAN ST NE, SUITE A721
GRAND RAPIDS, MI 49503
Kent County (616) 391-3139
MATTHEW H ARMSTRONG MD
Anesthesiology
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-1510
ALINE DE QUADROS TEIXEIRA MD
Internal Medicine
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-3139
DR. LINDSEY DANIELLE CONRADO PT, DPT
Physical Therapist
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (161) 639-1177
DANIEL H. ROBINSON D.O.
Anesthesiology
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-1510
MARK GREENWOOD DO
Emergency Medicine
100 MICHIGAN ST NE, MC 71
GRAND RAPIDS, MI 49503
Kent County (616) 391-5310
RAYMOND SCUREK MD
Emergency Medicine
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-1680
MRS. RACHEL LEIGH VANSTRIEN PA-C
Physician Assistant
100 MICHIGAN ST NE, SUITE 8861
GRAND RAPIDS, MI 49503
Kent County (616) 391-0800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Elloso's NPI number?

The NPI number for Matthew Elloso is 1447563150. It was assigned to this individual provider in the NPPES registry on July 22, 2010.

Where is Matthew Elloso located?

Matthew Elloso practices at 100 Michigan St NE Suite A721, Grand Rapids, MI 49503. The listed phone number is (616) 391-3139.

What is Matthew Elloso's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Matthew Elloso was last updated on June 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.