Individual provider Active NPI

Matthew Blair, PA-S

  • Physician Assistant
  • Marietta, OH
National Provider Identifier
1417661885
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
400 Matthew St Ste 302
Marietta, OH 45750-1656
Phone
(740) 568-5207
Fax
(740) 434-0578
NPI assigned
Jan 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

400 Matthew St Ste 302
Marietta, OH 45750-1656

Mailing address

5160 W 86TH PL
Crown Point, IN 46307-1608
Phone (219) 213-5668

Other practice location 1

803 Farson St Ste 400
Belpre, OH 45714-1073
Phone (740) 568-5207

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825004017 OH Practitioner - Physician Assistant 7618477449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Indiana University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

400 Matthew St
Marietta, OH 45750-1656

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Marietta Memorial Hospital Past Accepting new patients

Locations

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

416 Colegate Dr
#3
Marietta, OH 45750
Phone (740) 236-9047

Interoperability endpoints

  • Direct secure messaging: matthew.blair@mmhs.medicity.net

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 1

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": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1417661885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 W 86TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071608",
            "telephone_number": "219-213-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MATTHEW ST STE 302",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501656",
            "telephone_number": "740-568-5207",
            "fax_number": "740-434-0578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Farson St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Belpre",
            "state": "OH",
            "postal_code": "457141073",
            "country_code": "US",
            "telephone_number": "740-568-5207",
            "fax_number": "740-423-3622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.