NPIMap

Individual provider Active NPI

Matthew Alan Johansen, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Cincinnati, OH
National Provider Identifier
1265757769
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
35.129257 Issued in OH
Practice address
6480 Harrison Ave
Cincinnati, OH 45247-7961
Phone
(513) 354-3700
Fax
(513) 354-7651
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 0101258243 VA
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X D79334 MD
Student in an Organized Health Care Education/Training Program 390200000X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 35.129257 OH Primary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X TP268 KY

Addresses

Primary practice location

6480 Harrison Ave
Cincinnati, OH 45247-7961

Mailing address

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961
Phone (513) 354-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160804000771 OH Practitioner - Orthopedic Surgery 7517279516 Reassigns benefits to 1 organization
I20160810001273 KY Practitioner - Orthopedic Surgery 7517279516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wright State University Boonshoft School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

2010 N Bend Rd
Hebron, KY 41048-8003
Phone (859) 594-5220

600 Rodeo Dr
Erlanger, KY 41018-1279
Phone (513) 354-3700

6480 Harrison Ave
Cincinnati, OH 45247-7821
Phone (513) 354-3700

7567 Central Parke Blvd
Mason, OH 45040-6852

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement60
Knee replacement81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D79334MDMDAdult Reconstructive Orthopaedic Surgery Physician
0101258243VAMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Major Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matthew.johansen.p2@direct.beaconortho.nextgenshare.com
  • Direct secure messaging: matthew.johansen.p1@direct.beaconortho.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1265757769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-3700",
            "fax_number": "513-354-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "VA",
            "license": "0101258243",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MD",
            "license": "D79334",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "OH",
            "license": "35.129257",
            "primary": true
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "KY",
            "license": "TP268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.