Matthew McKinley Ellsworth, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

00426 Issued in KY

Practice address

613 23Rd St Ste G30
Ashland, KY 41101-2881

Phone

(606) 327-0036

Fax

(606) 326-1159

NPI assigned

May 3, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, OH, CO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Podiatry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Kings Daughters Medical Specialties IncGroup PAC ID 6103968029, shared by 2 NPIs, 397 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009
• Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023

Merit-based Incentive Payment System (MIPS)

Final score

84.04 of 100Reported as group

Quality

60.55

Promoting interoperability

100

Improvement activities

40

Cost

78.81

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mellsworth62896@direct.kdhealth.us

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.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment Care Compare group NPD
• Kings Daughters Medical Specialties Inc

  • Otolaryngology Physician
  • Ashland, KY
  • NPI 1497083539

  OH

  Medicare reassignment NPD
• Kings Daughters Medical Specialties Inc

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  Medicare reassignment NPD
• Kings Daughters Medical Specialties Inc

  • Family Medicine Physician
  • Ashland, KY
  • NPI 1669791323
  NPD
• Kings Daughters Medical Specialties Inc

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• Lexington Podiatry PSC

  • Durable Medical Equipment & Medical Supplies
  • Lexington, KY
  • NPI 1780341800
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Physical Medicine & Rehabilitation Physician
  • Delta, CO
  • NPI 1427712967
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• St Mary'S Hospital and Medical Center, Inc

  • Hematology & Oncology Physician
  • Grand Junction, CO
  • NPI 1275714081
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ashland Hospital Corporation

  • General Acute Care Hospital
  • Ashland, KY
  • NPI 1851346720
  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • Ambulance
  • Grand Junction, CO
  • NPI 1164060877

  Hospital

  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  Care Compare affiliation
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1821647801
  Care Compare affiliation
• St. Mary'S Hospital and Medical Center, Inc.

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1699716027
  Care Compare affiliation

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1124387618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE G30",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012881",
            "telephone_number": "606-327-0036",
            "fax_number": "606-326-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Scioto Trl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "OH",
            "postal_code": "456622845",
            "country_code": "US",
            "telephone_number": "740-353-8100",
            "fax_number": "740-353-8908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2483 Highway 644 Ste 103",
            "address_purpose": "LOCATION",
            "city": "Louisa",
            "state": "KY",
            "postal_code": "412309242",
            "country_code": "US",
            "telephone_number": "606-638-9954",
            "fax_number": "606-638-3590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MATTHEW",
        "middle_name": "MCKINLEY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36.003921",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "KY",
            "license": "00426",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "00426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100351750",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Treva Elliott, APRN
• Aaron Ellis
• Jason G. Ellis, CRNA
• Teresa D Ellis, CRNA
• Tyler Ellis
• Tiffany Elswick Haney, LCSW
• Matthew Dale Elswick
• Melissa Sue Emery, APRN- FNP-BC
• Amanda Endicott
• Megan Enyart, NP

• Podiatrist in Ashland, KY
• Providers in Ashland, KY by specialty
• Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.