NPIMap

Individual provider Active NPI

Charles Victor Matriano-Lim, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Akron, OH
National Provider Identifier
1306881818
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
35086701 Issued in OH
Practice address
525 E Market St
Suite 1-N
Akron, OH 44304-1619
Phone
(330) 375-3588
NPI assigned
Jun 18, 2006
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35086701 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35086701 OH Primary

Addresses

Primary practice location

525 E Market St
Suite 1-N
Akron, OH 44304-1619

Mailing address

525 E Market St
Suite 1-N
Akron, OH 44304-1619

Other practice location 1

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

Other identifiers 1

IdentifierTypeStateIssuer
2871423MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmatrianolim268108@direct.ccf.org ANESTHESIA CONSULTANTS, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080613000364 OH Practitioner - AnesthesiologyPractitioner - Emergency MedicinePractitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5496826703 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians
Anesthesia Consultants, IncGroup PAC ID 7911921317, 11 clinicians

Practice addresses (Care Compare)

155 5TH St NE
Barberton, OH 44203-3332

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35086701OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants, Inc Anesthesiology CurrentSince Nov 1, 2014 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince Jul 31, 2013 Accepting new patients
Summa Physicians LLC CurrentSince Jul 31, 2013 Accepting new patients
University Hospitals Medical Group Inc Anesthesiology CurrentSince Aug 14, 2017 Accepting new patients
Summa Health System Past Accepting new patients
Summa Physicians LLC Critical Care Medicine Past Accepting new patients
Summit County Intensive Care Physicians Inc Critical Care Medicine Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

525 E Market St
Ste 1N
Akron, OH 44304
Phone (330) 375-3588

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: cmatrianolim27106@summahealth-direct.org

Organizations & group practices 8

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 4

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1306881818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "address_2": "SUITE 1-N",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "address_2": "SUITE 1-N",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-375-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2420 Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Ashtabula",
            "state": "OH",
            "postal_code": "440044954",
            "country_code": "US",
            "telephone_number": "440-997-2262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATRIANO-LIM",
        "first_name": "CHARLES",
        "middle_name": "VICTOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35086701",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35086701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871423",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmatrianolim268108@direct.ccf.org",
            "affiliation": "Y",
            "affiliationName": "ANESTHESIA CONSULTANTS, INC",
            "address_1": "2420 Lake Ave",
            "city": "Ashtabula",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440044954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.