NPIMap

Individual provider Active NPI

Matthew Stephen Kelzer, PA-C

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1073950895
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003850RX Issued in OH
Practice address
1530 Needmore Rd Ste 300
Dayton, OH 45414-3980
Phone
(937) 277-4274
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003850RX OH Primary

Addresses

Primary practice location

1530 Needmore Rd Ste 300
Dayton, OH 45414-3980

Mailing address

1530 Needmore Rd Ste 300
Dayton, OH 45414-3980
Phone (937) 277-4274

Other practice location 1

2400 Lakeview Dr # 230
Beavercreek, OH 45431-2581
Phone (937) 320-0630

Other identifiers 1

IdentifierTypeStateIssuer
0096509MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140924000058 OH Practitioner - Physician Assistant 6002035037 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Berry Women'S Center Labor and Delivery
Dayton, OH 45409-2939
Phone (937) 439-4381

1530 Needmore Rd
Suite 300
Dayton, OH 45414-3980
Phone (937) 277-4274

2300 Miami Valley Dr
FL 4
Centerville, OH 45459-4779
Phone (937) 276-8320

2400 Lakeview Dr
Beavercreek, OH 45431-2581

30 E Apple St
Dayton, OH 45409-2939

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Physician Assistant CurrentSince Oct 23, 2023 Accepting new patients
Alliance Physicians Inc CurrentSince Apr 15, 2019 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 23, 2023 Accepting new patients
Alliance Physicians Inc CurrentSince Apr 15, 2019 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1530 Needmore Rd
Ste 300
Dayton, OH 45414
Phone (937) 208-6745

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Ste 101
Englewood, OH 45415

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

700 S Stanfield Rd
Ste A
Troy, OH 45373
Phone (934) 339-5355

600 W Main St
Ste 330
Troy, OH 45373
Phone (937) 429-7350

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Interoperability endpoints

  • Direct secure messaging: mkelzer512559@direct.ketteringhealth.org

Organizations & group practices 7

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 3

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": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1073950895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143980",
            "telephone_number": "937-277-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 NEEDMORE RD STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143980",
            "telephone_number": "937-277-4274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Lakeview Dr # 230",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454312581",
            "country_code": "US",
            "telephone_number": "937-320-0630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELZER",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-03",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003850RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096509",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.