Individual provider Active NPI

Matthew Albert Lavalle, MD

  • Anesthesiology Physician
  • Cape Girardeau, MO
National Provider Identifier
1063521078
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2001002335 Issued in MO
Practice address
211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone
(573) 334-7575
Fax
(573) 334-7512
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 2001002335 MO
Pain Medicine (Anesthesiology) Physician 207LP2900X 2001002335 MO
Anesthesiology Physician 207L00000X 2001002335 MO Primary

Addresses

Primary practice location

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other identifiers 3

IdentifierTypeStateIssuer
461684OtherHEALTHLINK
205317407MedicaidMO
105181OtherMOBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20090729000174 MO Practitioner - Anesthesiology 7214086354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Missouri, Columbia School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

211 Saint Francis Dr
Cape Girardeau, MO 63703-5049
Phone (573) 331-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Aug 7, 2023 Accepting new patients
Resource Anesthesiology Associates of Mo LLC Anesthesiology CurrentSince Aug 15, 2017 Accepting new patients
Saint Francis Medical Center Anesthesiology Current Accepting new patients
Saint Francis Medical Center CurrentSince Aug 7, 2023 Accepting new patients
Anesthesia Associates of Cape Girardeau PC Anesthesiology Current Accepting new patients
Anesthesia Associates of Cape Girardeau Current Accepting new patients

Locations

721 N Sunset Blvd
Cpe Girardeau, MO 63701
Phone (573) 335-0185

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

30 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-9606

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

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.

Hospital & facility affiliations 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1063521078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SAINT FRANCIS DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035049",
            "telephone_number": "573-334-7575",
            "fax_number": "573-334-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLE",
        "first_name": "MATTHEW",
        "middle_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MO",
            "license": "2001002335",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2001002335",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2001002335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "461684",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205317407",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "105181",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.