Individual provider Active NPI

Matthew Joseph Pawlaczyk, CRNA

  • Certified Registered Nurse Anesthetist
  • Oregon, OH
National Provider Identifier
1235782988
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019945 Issued in OH
Practice address
2600 Navarre Ave
Oregon, OH 43616-3207
Phone
(419) 696-7200
NPI assigned
Jul 22, 2019
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.019945 OH Primary

Addresses

Primary practice location

2600 Navarre Ave
Oregon, OH 43616-3207

Mailing address

6049 Fountain Pointe Apt 9
Grand Blanc, MI 48439-7786
Phone (419) 260-0462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018002710 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597096743 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Michigan Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

139 Garau St
Bluffton, OH 45817-1027
Phone (419) 358-9010

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.98 of 100Reported as group
Quality
55.52
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Blanchard Valley Regional Health Center Current Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
Northstar Anesthesia of Ohio LLC Anesthesiology CurrentSince Sep 12, 2019 Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Oct 7, 2019 Accepting new patients
Blanchard Valley Regional Health Center Anesthesiology CurrentSince Oct 7, 2019 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients

Locations

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

139 Garau St
Bluffton, OH 45817
Phone (419) 358-9010

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

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

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1235782988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6049 FOUNTAIN POINTE APT 9",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397786",
            "telephone_number": "419-260-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163207",
            "telephone_number": "419-696-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLACZYK",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.