Individual provider Active NPI

Matthew P. Koehler II, M.D.

  • Ophthalmology Physician
  • Mount Vernon, OH
National Provider Identifier
1164652178
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35129579 Issued in OH
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050
Phone
(740) 393-9000
Fax
(740) 392-0167
NPI assigned
Jul 24, 2009
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 129579 OH
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 35129579 OH Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050

Mailing address

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180824001431 OH Practitioner - Ophthalmology 4385887587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio University, College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1355 Yauger Rd
Mount Vernon, OH 43050-9233
Phone (740) 397-2425

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35129579OHMDOphthalmology Physician
129579OHMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Aug 1, 2018 Accepting new patients
Knox Community Hospital CurrentSince Aug 1, 2018 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients

Locations

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

1355 Yauger Rd
Mount Vernon, OH 43050
Phone (614) 397-2425

Organizations & group practices 5

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 1

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1164652178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "MATTHEW",
        "middle_name": "P.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "OH",
            "license": "129579",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35129579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.