Individual provider Active NPI

Matthew Carlisle Hagen, M.D., PH.D.

  • Neuropathology Physician
  • Cincinnati, OH
National Provider Identifier
1447411251
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuropathology PhysicianTaxonomy code 207ZN0500X
License
35 097773 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 584-7284
Fax
(513) 584-3807
NPI assigned
Jun 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35097773 OH
Neuropathology Physician 207ZN0500X 35 097773 OH Primary

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

PO Box 636256 Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5507

Other identifiers 1

IdentifierTypeStateIssuer
0051637MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111014000461 OH Practitioner - Pathology 4284806399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2123 Auburn Ave
Cincinnati, OH 45219-2906

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35 097773OHMDNeuropathology Physician
35097773OHMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC CurrentSince Jan 1, 2012 Accepting new patients

Locations

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

70 Damon Rd
Cincinnati, OH 45218
Phone (513) 605-1000

Interoperability endpoints

  • Direct secure messaging: mhagen28267@direct.uchealth.com

Organizations & group practices 1

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 3

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": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1447411251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256 CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5507",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-584-7284",
            "fax_number": "513-584-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "MATTHEW",
        "middle_name": "CARLISLE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-24",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35097773",
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "OH",
            "license": "35 097773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.