Individual provider Active NPI

Matthew Craig Bromley, D.O.

  • Emergency Medicine Physician
  • Newark, OH
National Provider Identifier
1003023771
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
58.002211 Issued in OH
Practice address
1320 W Main St
Newark, OH 43055-1822
Phone
(220) 564-4151
Fax
(220) 564-7153
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34009463 OH
Emergency Medicine Physician 207P00000X 58.002211 OH Primary

Addresses

Primary practice location

1320 W Main St
Newark, OH 43055-1822

Mailing address

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-4151

Other practice location 1

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7153

Other practice location 2

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7153

Other identifiers 1

IdentifierTypeStateIssuer
2997128MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbromley14312@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION
Direct Messaging Address mbromley14312@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091203000766 OH Practitioner - Emergency Medicine 2365581337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New England, College of Osteo Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055-1822

36 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

88 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34009463OHMDEmergency Medicine Physician
58.002211OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corporation CurrentSince Oct 8, 2009 Accepting new patients
Licking Memorial Health Professionals CurrentSince Oct 8, 2009 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1003023771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551822",
            "telephone_number": "220-564-4151",
            "fax_number": "220-564-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "MATTHEW",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34009463",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58.002211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2997128",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbromley14312@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbromley14312@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.