Individual provider Active NPI

Corey Ray Matthews, D.O.

  • Pediatric Radiology Physician
  • Minneapolis, MN
National Provider Identifier
1063888345
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
69917 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-6248
Fax
(612) 813-6397
NPI assigned
Aug 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X DR.0070390 CO
Pediatric Radiology Physician 2085P0229X 05514 KY
Pediatric Radiology Physician 2085P0229X 69917 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6248

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other practice location 2

231 E Chestnut St
Louisville, KY 40202-1821
Phone (502) 629-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TN, CA, KY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20220531000161 MN Practitioner - Diagnostic RadiologyPractitioner - Nuclear MedicinePractitioner - Pediatric Medicine 7719365980 Reassigns benefits to 3 organizations
I20230818001230 TN Practitioner - Diagnostic Radiology 7719365980 Reassigns benefits to 1 organization
I20231229000484 CA Practitioner - Diagnostic Radiology 7719365980 Reassigns benefits to 2 organizations
I20241209001521 KY Practitioner - Pediatric Medicine 7719365980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine, Pediatric Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Children's Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

Minneapolis, MN 55404-4597
Phone (612) 813-6111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.07
Promoting interoperability
100
Improvement activities
40
Cost
76.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0070390COMDPediatric Radiology Physician
21194CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Aug 1, 2024 Accepting new patients
Kaleida Health CurrentSince Jan 20, 2025 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC Pediatric Radiology CurrentSince Sep 26, 2024 Accepting new patients
University of California San Francisco Diagnostic Radiology CurrentSince Dec 14, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Dec 14, 2023 Accepting new patients
Childrens Health Care Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Dec 14, 2023 Accepting new patients
Kaleida Health Diagnostic Radiology CurrentSince Jan 20, 2025 Accepting new patients
Childrens Health Care CurrentSince Apr 25, 2022 Accepting new patients
Children's Health Care CurrentSince Apr 25, 2022 Accepting new patients
University of California San Francisco CurrentSince Dec 14, 2023 Accepting new patients
Childrens Health Care Services Inc CurrentSince Jul 12, 2022 Accepting new patients
University of California San Francisco Current Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2024 Accepting new patients
Norton Childrens Medical Group, LLC Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

6050 Clearwater Dr
Minnetonka, MN 55343
Phone (952) 930-8600

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

Interoperability endpoints

  • Direct secure messaging: cmatthews24389@mlh.direct-ci.com

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1063888345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6248",
            "fax_number": "612-813-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6248",
            "fax_number": "612-813-6397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021821",
            "country_code": "US",
            "telephone_number": "502-629-7650",
            "fax_number": "502-629-7663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "COREY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CO",
            "license": "DR.0070390",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "KY",
            "license": "05514",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MN",
            "license": "69917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.