Active NPI
Mattie Arseneaux
- Trauma Surgery Physician
- Champaign, IL
National Provider Identifier
1295260032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- 036171507
- Practice address
- 3105 Fields South Dr
Champaign, IL 61822-3743 - Phone
- (217) 383-3240
- NPI assigned
- Apr 30, 2017
- Last updated
- Nov 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Surgery Physician | 208600000X | PG183132 | OR | |
| Trauma Surgery Physician | 2086S0127X | 036171507 | IL | Primary |
Addresses
Primary practice location
3105 Fields South Dr
Champaign, IL 61822-3743
Mailing address
611 W Park St
Fapc
Urbana, IL 61801-2500
Other practice location 1
147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Foundation Hospital
- St Anthonys Memorial Hospital
- Osf Sacred Heart Medical Center
- Kirby Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PG183132 | OR | MD | Surgery Physician |
| 036171507 | IL | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Medical Group | Current | Accepting new patients | |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
3105 Fields South Dr
Champaign, IL 61822
Phone (217) 902-3277
3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- marseneauxdo421365@carlehiedirect.net
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- Durable Medical Equipment & Medical Supplies
- Champaign, IL
- NPI 1114240876
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Monticello, IL
- NPI 1730179847
-
dba OSF Sacred Heart Medical Center
- General Acute Care Hospital
- Danville, IL
- NPI 1699288449
-
dba St. Anthony's Memorial Hospital
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
dba St. Anthony's Memorial Hospitral
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1295260032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"address_2": "FAPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 FIELDS SOUTH DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618223743",
"telephone_number": "217-383-3240"
}
],
"practiceLocations": [
{
"address_1": "147 N Brent St",
"address_purpose": "LOCATION",
"city": "Ventura",
"state": "CA",
"postal_code": "93003",
"country_code": "US",
"telephone_number": "805-652-5011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARSENEAUX",
"first_name": "MATTIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-30",
"last_updated": "2024-11-08",
"certification_date": "2024-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OR",
"license": "PG183132",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "IL",
"license": "036171507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.