NPIMap

Individual provider Active NPI

Matthew C Birdwhistell, D.O.

  • Internal Medicine Physician
  • Georgetown, KY
National Provider Identifier
1043457757
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
03293 Issued in KY
Practice address
1138 Lexington Rd
Suite 290
Georgetown, KY 40324-9672
Phone
(502) 863-0721
Fax
(502) 863-6104
NPI assigned
Jan 16, 2009
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 03293 KY Primary

Addresses

Primary practice location

1138 Lexington Rd
Suite 290
Georgetown, KY 40324-9672

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other identifiers 2

IdentifierTypeStateIssuer
03293OtherKYLICENSE
7100160510MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000384 KY Practitioner - Internal Medicine 0143407742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proactive Therapy, IncGroup PAC ID 0143245415, 118 clinicians
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

1004 Leawood Dr
Frankfort, KY 40601-3349
Phone (502) 223-7403

1138 Lexington Rd
Suite 290
Georgetown, KY 40324-9672
Phone (502) 863-0721

1207 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1225 S Broadway
Suite 201
Lexington, KY 40504-2701
Phone (859) 258-4568

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic PSC CurrentSince Sep 1, 2023 Accepting new patients
New Lexington Clinic, PSC Internal Medicine CurrentSince Sep 1, 2023 Accepting new patients

Locations

1138 Lexington Rd
Ste 290
Georgetown, KY 40324
Phone (502) 542-9118

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

Interoperability endpoints

  • Direct secure messaging: jfa8409@yourcarecommunity.org
  • Direct secure messaging: matthew.birdwhistell.1@13059.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1043457757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 LEXINGTON RD",
            "address_2": "SUITE 290",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249672",
            "telephone_number": "502-863-0721",
            "fax_number": "502-863-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDWHISTELL",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "03293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "03293",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100160510",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.