NPIMap

Individual provider Active NPI

Matthew T Langenberg, M.D.

  • Vascular Surgery Physician
  • Evansville, IN
National Provider Identifier
1407845159
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
01075972A Issued in IN
Practice address
520 Mary St
Ste 520
Evansville, IN 47710
Phone
(812) 424-8231
Fax
(812) 435-8794
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 01075972A IN Primary

Addresses

Primary practice location

520 Mary St
Ste 520
Evansville, IN 47710

Mailing address

520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Other identifiers 4

IdentifierTypeStateIssuer
7100229330MedicaidKY
000000978343OtherINANTHEM BLUE CROSS BLUE SHIELD
201332370MedicaidIN
XXXXXXXXX001MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000828 OH Practitioner - Vascular SurgeryPractitioner - General Surgery 7012934425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Firelands Regional Medical CenterGroup PAC ID 6103734645, shared by 5 NPIs, 20 clinicians
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (419) 557-7400

703 Tyler St
Suite 351
Sandusky, OH 44870-3391
Phone (419) 621-7620

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)24
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01075972AINMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Jan 1, 2020 Accepting new patients
North Coast Professional Company, LLC CurrentSince Jan 1, 2020 Accepting new patients
Warren General Hospital PastSince Apr 1, 2006 Accepting new patients
Firelands Regional Medical Center Past Accepting new patients
Warren General Hospital Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1400 W Main St
Bellevue, OH 44811
Phone (330) 563-0641

1400 W Main St
Ste A
Bellevue, OH 44811
Phone (419) 483-2494

292 Benedict Ave
Norwalk, OH 44857
Phone (419) 663-3737

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

703 Tyler St
Ste 351
Sandusky, OH 44870
Phone (419) 621-7620

Interoperability endpoints

  • Direct secure messaging: matthew.langenberg@evansvillesurgical.directbygreenway.com
  • Direct secure messaging: matthew.langenberg@fpg.medicity.net

Organizations & group practices 6

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 6

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1407845159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST",
            "address_2": "STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47710",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGENBERG",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "01075972A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100229330",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "000000978343",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201332370",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XXXXXXXXX001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.