Individual provider Active NPI

Megan Carol Matrisciano, PA-C

  • Physician Assistant
  • Sylvania, OH
National Provider Identifier
1225585698
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006041RX Issued in OH
Practice address
2121 Hughes Drive, HMT #710
Sylvania, OH 43560
Phone
(419) 291-2671
Fax
(419) 291-2680
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X 1154529
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 50.006041RX OH Primary

Addresses

Primary practice location

2121 Hughes Drive, HMT #710
Sylvania, OH 43560

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmatrisciano247301@epicdirect.promedica.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401000749 OH Practitioner - Physician Assistant 6800225517 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2901 N Reynolds Rd
Toledo, OH 43606
Phone (419) 578-7700

5200 Harroun Rd
Sylvania, OH 43560-2168
Phone (419) 824-1444

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Fostoria Community Hospital Hospital, Fostoria, OH, CCN 361318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006041RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Mar 30, 2020 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Physician Assistant CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Mar 30, 2020 Accepting new patients
Promedica Central Physicians Physician Assistant CurrentSince Aug 1, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

2109 Hughes Dr
Ste 760
Toledo, OH 43606
Phone (419) 291-7555

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: mmatrisciano247301@direct.promedica.org

Organizations & group practices 6

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 6

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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1225585698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DRIVE, HMT #710",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "43560",
            "telephone_number": "419-291-2671",
            "fax_number": "419-291-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATRISCIANO",
        "first_name": "MEGAN",
        "middle_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2023-11-03",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1154529",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006041RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmatrisciano247301@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.