Individual provider Active NPI

Matthew David Campos

  • Internal Medicine Physician
  • Lancaster, OH
National Provider Identifier
1366785503
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.127803 Issued in OH
Practice address
401 N Ewing St
Lancaster, OH 43130-3372
Phone
(614) 566-3322
NPI assigned
Apr 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.127803 OH Primary

Addresses

Primary practice location

401 N Ewing St
Lancaster, OH 43130-3372

Mailing address

401 N Ewing St
Lancaster, OH 43130-3372
Phone (614) 566-3322

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
I20160419000822 OH Practitioner - Internal Medicine 3577703545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 N Ewing St
Lancaster, OH 43130-3372
Phone (740) 689-6680

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.95 of 100Reported as group
Quality
43.39
Promoting interoperability
100
Improvement activities
40
Cost
76.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.127803OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals Inc CurrentSince Jul 1, 2017 Accepting new patients
Community Hospitalist, LLC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Fairfield Healthcare Professionals, Inc. CurrentSince Jul 1, 2017 Accepting new patients
Fairfield Medical Center Past Accepting new patients

Locations

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

131 N Ewing St
Ste C
Lancaster, OH 43130
Phone (740) 689-6600

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f17aed19-e2f6-49d4-bba0-64508a2357d2/

Organizations & group practices 4

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 2

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": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1366785503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303372",
            "telephone_number": "614-566-3322",
            "fax_number": "614-566-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303372",
            "telephone_number": "614-566-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-05",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.127803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.