Individual provider Active NPI

Matthew Joseph Mivsek, DO

  • Family Medicine Physician
  • Hudson, OH
National Provider Identifier
1245623149
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.012484 Issued in OH
Practice address
231 Seasons Rd
Suite 300
Hudson, OH 44224
Phone
(330) 662-5666
Fax
(330) 655-3845
NPI assigned
Mar 17, 2015
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.012484 OH Primary

Addresses

Primary practice location

231 Seasons Rd
Suite 300
Hudson, OH 44224

Mailing address

231 Seasons Rd
Suite 300
Hudson, OH 44224
Phone (330) 662-5666

Other identifiers 1

IdentifierTypeStateIssuer
0230659MedicaidOH

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
I20170613002318 OH Practitioner - Family Practice 1951679026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Health Network LLCGroup PAC ID 0244379717, 59 clinicians

Practice addresses (Care Compare)

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

231 Seasons Rd
Suite 300
Cuyahoga Falls, OH 44224-1015
Phone (330) 662-5666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.012484OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Network, LLC CurrentSince Jun 1, 2018 Accepting new patients
Unity Health Network, LLC Family Medicine CurrentSince Jun 1, 2018 Accepting new patients

Locations

231 Seasons Rd
Ste 300
Cuyahoga Falls, OH 44224
Phone (330) 662-5666

3033 State Rd
Ste 101
Cuyahoga Fls, OH 44223
Phone (330) 923-8372

3033 State Rd
Ste 204
Cuyahoga Fls, OH 44223
Phone (330) 253-9727

1900 23rd St
Cuyahoga Fls, OH 44223
Phone (330) 929-2685

5655 Hudson Dr
Ste 130
Hudson, OH 44236
Phone (330) 655-3820

Organizations & group practices 2

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 5

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": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1245623149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 SEASONS RD",
            "address_2": "SUITE 300",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44224",
            "telephone_number": "330-662-5666",
            "fax_number": "330-655-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 SEASONS RD",
            "address_2": "SUITE 300",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "44224",
            "telephone_number": "330-662-5666",
            "fax_number": "330-655-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIVSEK",
        "first_name": "MATTHEW",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-17",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.012484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230659",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

Verify at the official NPI Registry.