Individual provider Active NPI

Matthew Patel, M.D.

  • Emergency Medicine Physician
  • Wilmington, OH
National Provider Identifier
1013995562
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35069630 Issued in OH
Practice address
610 W Main St
Wilmington, OH 45177-2125
Phone
(937) 383-1040
Fax
(937) 383-1380
NPI assigned
Jan 5, 2006
Last updated
Jul 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35069630 OH Primary

Addresses

Primary practice location

610 W Main St
Wilmington, OH 45177-2125

Mailing address

PO Box 931267
Cleveland, OH 44193-1484
Phone (440) 777-6017

Other identifiers 1

IdentifierTypeStateIssuer
0310809MedicaidOH

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
I20090706000221 OH Practitioner - Emergency Medicine 7416905096 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35069630OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Talawanda Emergency Physicians, Inc. Emergency Medicine CurrentSince Nov 6, 2012 Accepting new patients
Qualified Emergency Specialists Inc Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Intelligent Imaging Resources LLC PastSince Jan 11, 2005 Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients
Clinton Memorial Hospital of Wilmington Clinton County Ohio Past Accepting new patients
Professional Emergency Specialists of Southern Ohio Emergency Medicine Past Accepting new patients

Locations

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

110 N Poplar St
Oxford, OH 45056
Phone (513) 523-2111

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248134400000",
    "number": "1013995562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931267",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441931484",
            "telephone_number": "440-777-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W MAIN ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772125",
            "telephone_number": "937-383-1040",
            "fax_number": "937-383-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2009-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35069630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310809",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, OH

Sources for this page

Verify at the official NPI Registry.