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MATTHEW CUSTODIO
NPI 1770042988
Internal Medicine - Gastroenterology in Philadelphia, PA

Active since March 18, 2019PECOS EnrolledAccepts Medicare Assignment
333 COTTMAN AVE, PHILADELPHIA, PA 19111(215) 214-1424(215) 214-1425 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Matthew Custodio NPPES

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

MATTHEW CUSTODIO (NPI 1770042988) is an individual gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD489166) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of State University Of New York Downstate Medical Center (2019).

NPPES Registry Identity

NPI1770042988
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameMATTHEW CUSTODIO
Location Address333 COTTMAN AVEPhiladelphia, PA 19111-2434
Mailing Address3401 N Broad StPhiladelphia, PA 19140-5103 · (215) 707-2433
Phone(215) 214-1424
Fax(215) 214-1425
Sole ProprietorNo
Medical School CMSState University Of New York Downstate Medical CenterGraduated 2019
Enumeration DateMarch 18, 2019
Last NPPES UpdateFebruary 13, 2026
NPPES CertifiedFebruary 13, 2026
✔ NPI 1770042988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in PA · MD489166
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
333 COTTMAN AVE, Philadelphia, PA 19111
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Custodio is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476889338
PECOS Enrollment IDI20260225000456
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Matthew Custodio reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Temple Faculty Practice Plan, Inc
Same address
Neurology
333 COTTMAN AVE
Philadelphia, PA 19111
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,991 clinicians in this Medicare group
NPI 1093298887 (215) 728-6900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

FOX CHASE CANCER CENTER MEDICAL GROUP, INC.
Anesthesiology
333 COTTMAN AVE, MED STAFF OFFICE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
JAMES SUN MD
Surgery (Surgical Oncology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 854-9799
MS. MALA T KAILASAM MD
Internal Medicine
333 COTTMAN AVE, FOX CHASE CANCER CENTER
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
HEALTH SERVICES OF FOX CHASE CANCER CTR.
Radiology (Diagnostic Radiology)
333 COTTMAN AVE, RADIOLOGY ASSOCIATES OF FCCC
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
ELENA DREYZIN PA-C
Physician Assistant
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (888) 369-2427
FREWEINI TESFALEDET PA
Physician Assistant
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-6900
MARIUSZ A WASIK MD
Pathology (Anatomic Pathology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-3675
DR. BARBARA C. CAVANAUGH M.D.
Radiology (Diagnostic Radiology)
333 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 728-3883

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 Custodio's NPI number?

The NPI number for Matthew Custodio is 1770042988. It was assigned to this individual provider in the NPPES registry on March 18, 2019.

Where is Matthew Custodio located?

Matthew Custodio practices at 333 Cottman Ave, Philadelphia, PA 19111. The listed phone number is (215) 214-1424.

What is Matthew Custodio's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Matthew Custodio enrolled in Medicare?

Yes. Matthew Custodio is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Matthew Custodio's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Custodio reassigns Medicare benefits to Temple Faculty Practice Plan, Inc (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Matthew Custodio's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Matthew Custodio was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.