Individual provider Active NPI

Shevan Matto, M.D.

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1346772068
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35139866 Issued in OH
Practice address
2200 Jefferson Ave
Toledo, OH 43604-7101
Phone
(419) 251-1400
Fax
(419) 251-1797
NPI assigned
Mar 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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 35139866 OH Primary

Addresses

Primary practice location

2200 Jefferson Ave
Toledo, OH 43604-7101

Mailing address

2200 Jefferson Ave
Toledo, OH 43604-7101

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
I20200715000681 OH Practitioner - Family Practice 5193148757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians
Mercy Health Physicians North Specialty Care LLCGroup PAC ID 1951707884, 345 clinicians

Practice addresses (Care Compare)

2200 Jefferson Ave
Toledo, OH 43604-7101
Phone (419) 225-1400

2213 Cherry St
Toledo, OH 43608-2603

3404 W Sylvania Ave
Toledo, OH 43623-4467
Phone (419) 407-2663

3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35139866OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blanchard Valley Regional Health Center Family Medicine CurrentSince Dec 11, 2020 Accepting new patients
Blanchard Valley Regional Health Center Family Medicine Current Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Nov 27, 2023 Accepting new patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Jul 31, 2020 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jul 31, 2020 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Nov 27, 2023 Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Dec 11, 2020 Accepting new patients
Mercy Health - St Vincent Medical Center LLC Past Accepting new patients

Locations

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2200 Jefferson Ave
Toledo, OH 43604
Phone (419) 241-1400

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: smatto234354@direct.bsmhealth.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1346772068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101",
            "telephone_number": "419-251-1400",
            "fax_number": "419-251-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTO",
        "first_name": "SHEVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35139866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.