NPIMap

Individual provider Active NPI

Matthew Ellenberg, DO

  • Emergency Medicine Physician
  • Richmond, VA
National Provider Identifier
1427635150
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0102210171 Issued in VA
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
NPI assigned
Mar 27, 2021
Last updated
Jul 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X OT022091 PA
Emergency Medicine Physician 207P00000X 0102210171 VA Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

5801 Bremo Rd
Richmond, VA 23226-1900
Phone (804) 285-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, VA2 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
I20251126003298 PA Practitioner - Emergency Medicine 1153724497 Reassigns benefits to 4 organizations
I20260623000367 VA Practitioner - Emergency Medicine 1153724497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J C Blair Memorial HospitalGroup PAC ID 2668378407, 98 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians
Windber Hospital IncGroup PAC ID 9234187576, 37 clinicians

Practice addresses (Care Compare)

1225 Warm Springs Ave
PHHD Emergency Dept
Huntingdon, PA 16652-2350
Phone (814) 643-8206

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

600 Somerset Ave
Windber, PA 15963-1331
Phone (814) 467-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tyrone Hospital CurrentSince Sep 18, 2025 Accepting new patients
J C Blair Memorial Hospital CurrentSince Sep 18, 2025 Accepting new patients
Tyrone Hospital CurrentSince Dec 1, 2025 Accepting new patients
Tyrone Hospital CurrentSince Sep 18, 2025 Accepting new patients
J C Blair Memorial Hospital Current Accepting new patients
J C Blair Memorial Hospital CurrentSince Sep 18, 2025 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

239 Colonnade Blvd
Ph Sc
State College, PA 16803
Phone (582) 220-2345

187 Hospital Dr
Tyrone, PA 16686
Phone (814) 342-2333

Organizations & group practices 9

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1427635150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261900",
            "telephone_number": "804-285-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-27",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT022091",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102210171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.