NPIMap

Individual provider Active NPI

Matthew C Kincade, M.D.

  • Urology Physician
  • Rogers, AR
National Provider Identifier
1396963658
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
E-12884 Issued in AR
Practice address
3333 S Pinnacle Hills Pkwy Ste 300a
Rogers, AR 72758-9000
Phone
(479) 271-7077
Fax
(479) 271-7035
NPI assigned
Apr 23, 2007
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2013004671 MO
Urology Physician 208800000X E-12884 AR Primary

Addresses

Primary practice location

3333 S Pinnacle Hills Pkwy Ste 300a
Rogers, AR 72758-9000

Mailing address

3333 S Pinnacle Hills Pkwy Ste 300a
Rogers, AR 72758-9000
Phone (479) 271-7077

Other practice location 1

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone (314) 251-8850

Other practice location 2

607 S New Ballas Rd Ste 3100
Saint Louis, MO 63141-8219
Phone (314) 251-8850

Other identifiers 4

IdentifierTypeStateIssuer
P01159463OtherMORR MCR
196652001MedicaidAR
1396963658MedicaidMO
431560263OtherMOTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130308000466 MO Practitioner - Urology 5991877508 Reassigns benefits to 3 organizations
I20200303001989 AR Practitioner - Urology 5991877508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arkansas College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-2300

3333 S Pinnacle Hills Pkwy
Suite 300B
Rogers, AR 72758-9000
Phone (479) 338-4600

940 W Mount Vernon St
100 MC Laboratory Services Nixa
Nixa, MO 65714-9613
Phone (417) 724-5220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince May 15, 2018 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jan 23, 2026 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 18, 2013 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 6, 2023 Accepting new patients
Sgoh Acquisition Inc CurrentSince Mar 22, 2022 Accepting new patients
Sgoh Acquisition Inc CurrentSince Mar 22, 2022 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 6, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 18, 2013 Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

3333 S Pinnacle Hills Pkwy
Ste 300A
Rogers, AR 72758
Phone (479) 271-7077

3333 S Pinnacle Hills Pkwy
Ste 300B
Rogers, AR 72758
Phone (479) 338-4600

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5200

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: mkincade327766@directb.mercy.net

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 12

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1396963658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S PINNACLE HILLS PKWY STE 300A",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589000",
            "telephone_number": "479-271-7077",
            "fax_number": "479-271-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S PINNACLE HILLS PKWY STE 300A",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589000",
            "telephone_number": "479-271-7077",
            "fax_number": "479-271-7035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 S New Ballas Rd Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418219",
            "country_code": "US",
            "telephone_number": "314-251-8850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 S New Ballas Rd Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418219",
            "country_code": "US",
            "telephone_number": "314-251-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCADE",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2013004671",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "E-12884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P01159463",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196652001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396963658",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.