Individual provider Active NPI

Matthew W Crittendon, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1306953369
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01058985A Issued in IN
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 274-4705
Fax
(317) 278-0943
NPI assigned
Aug 24, 2006
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01058985A IN Primary

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Ste 130 Provider Enrollment
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
200501010MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20041228000535 IN Practitioner - Emergency Medicine 5890753560 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview HospitalGroup PAC ID 1153216627, 209 clinicians

Practice addresses (Care Compare)

395 Westfield Rd
Wound Care
Noblesville, IN 46060-1425
Phone (317) 773-0760

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01058985AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Hospital Emergency Medicine CurrentSince Aug 1, 2018 Accepting new patients
Riverview Hospital CurrentSince Aug 1, 2018 Accepting new patients
Lafayette Emergency Physicians, Inc Emergency Medicine CurrentSince Dec 2, 2017 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Nov 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients
Icem-University-Riley, LLC Emergency Medicine Past Accepting new patients
Chenango Memorial Hospital, Inc. Emergency Medicine Past Accepting new patients
Emgi - University, LLC Past Accepting new patients
Emergency Medicine Physicians of Cortland County, PLLC Emergency Medicine Past Accepting new patients
Emgi - Riley, LLC Emergency Medicine Past Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

1125 W Jefferson St
Franklin, IN 46131
Phone (317) 346-3858

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

702 Barnhill Dr
Indianapolis, IN 46202
Phone (317) 274-0273

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

1701 S Creasy Ln
Lafayette, IN 47905
Phone (765) 502-4400

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

865 Westfield Rd
Noblesville, IN 46062
Phone (317) 770-1700

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

6085 Heartland Dr
Zionsville, IN 46077
Phone (317) 768-2100

Organizations & group practices 11

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 1

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1306953369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "address_2": "STE 130 PROVIDER ENROLLMENT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-274-4705",
            "fax_number": "317-278-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITTENDON",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01058985A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200501010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.