Kevin K Matsuba, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD24745 Issued in OR

Practice address

2314 NW Kings Blvd
Corvallis, OR 97330-3925

Phone

(541) 758-5047

Fax

(541) 758-3713

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Diagnostic Radiology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santiam Hospital & Clinics Hospital, Stayton, OR, CCN 380056
• Salem Hospital Hospital, Salem, OR, CCN 380051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Medicare reassignment Care Compare group NPD
• Corvallis MRI a Joint Venture

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Corvallis, OR
  • NPI 1952529620
  NPD
• East Linn MRI, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Lebanon, OR
  • NPI 1417135880
  NPD
• Santiam Memorial Hospital

  • Family Medicine Physician
  • Mill City, OR
  • NPI 1205048097
  NPD
• Santiam Memorial Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stayton, OR
  • NPI 1801787171
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation
• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Care Compare affiliation
• Santiam Memorial Hospital

  • Ambulance
  • Stayton, OR
  • NPI 1962566752

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1376500710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 NW KINGS BLVD",
            "address_2": "PO BOX 1418",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-758-5047",
            "fax_number": "541-758-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303925",
            "telephone_number": "541-758-5047",
            "fax_number": "541-758-3713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 SW Abbey St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "OR",
            "postal_code": "973654820",
            "country_code": "US",
            "telephone_number": "541-265-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSUBA",
        "first_name": "KEVIN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD24745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297559",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmatsuba7649@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "930 SW Abbey St",
            "city": "Newport",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973654820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Mason, DPT
• Sara Joy Massey
• Jesse Enrique Mata
• Geoffrey Mathews, BS
• Omega Lynn Mathews
• Yu Matsumoto, DO
• Starr Matsushita, DO
• Emma Matteo, RN
• David Matthews
• Patricia L. Matthews, LCSW

• Diagnostic Radiology Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Diagnostic Radiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.

Verify at the official NPI Registry.