NPIMap

Individual provider Active NPI

Matthew Blaine Lebaron, DO

  • Sports Medicine (Family Medicine) Physician
  • Ozark, MO
National Provider Identifier
1164913448
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
2021010782 Issued in MO
Practice address
3050 E River Bluff Blvd
Ozark, MO 65721-8807
Phone
(417) 820-2829
NPI assigned
May 23, 2018
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IN
Sports Medicine (Family Medicine) Physician 207QS0010X 2021010782 MO Primary

Addresses

Primary practice location

3050 E River Bluff Blvd
Ozark, MO 65721-8807

Mailing address

3050 E River Bluff Blvd
Ozark, MO 65721-8807
Phone (417) 820-2829

Other practice location 1

5230 E Stop 11 Rd Ste 250
Indianapolis, IN 46237-6399
Phone (317) 528-8921

Other practice location 2

331 Hospital Dr Ste A
Lebanon, MO 65536-9251
Phone (417) 533-6560

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlebaron394732@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220824000353 MO Practitioner - Family Practice 5092062794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

3050 E River Bluff Blvd
MC Orthopedics
Ozark, MO 65721-8807
Phone (417) 820-5610

331 Hospital Dr
Suite a
Lebanon, MO 65536-9251
Phone (417) 533-6560

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Major Hospital Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

331 Hospital Dr
Ste A
Lebanon, MO 65536
Phone (417) 532-8856

3050 E River Bluff Blvd
Ozark, MO 65721
Phone (417) 820-5610

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: mlebaron394732@direct.franciscanalliance.org

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1164913448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 E RIVER BLUFF BLVD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218807",
            "telephone_number": "417-820-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 E RIVER BLUFF BLVD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218807",
            "telephone_number": "417-820-2829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5230 E Stop 11 Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462376399",
            "country_code": "US",
            "telephone_number": "317-528-8921",
            "fax_number": "137-528-6916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "331 Hospital Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655369251",
            "country_code": "US",
            "telephone_number": "417-533-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBARON",
        "first_name": "MATTHEW",
        "middle_name": "BLAINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MO",
            "license": "2021010782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlebaron394732@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5230 E Stop 11 Rd Ste 250",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462376399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ozark, MO

Sources for this page

Verify at the official NPI Registry.