Matthew E Hiestand, MD
Individual provider Active NPI Internal Medicine Physician · Bolivar, OH
NPI 1497723613 · NPPES record last updated Feb 17, 2012
Key facts
- NPI
- 1497723613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 35070029H (OH)
- Practice address
- 10724 State Route 212 NE
Bolivar, OH 44612-8740 - Phone
- (330) 874-7165
- Fax
- (330) 874-7166
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Medical College of Ohio, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orrville Hospital Foundation
Practice addresses (Care Compare)
10724 State Route 212 NE
Bolivar, OH 44612-8740
Phone (330) 874-7165
2600 6TH St SW
Canton, OH 44710-1702
832 S Main St
Orrville, OH 44667-2208
Phone (330) 682-3010
Hospital & facility affiliations
- Advantage Home Health Services, Inc
- Aultman Orrville Hospital
- Aultman Hospital
- Union Hospital
- Hennis Care Centre of Bolivar
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100707000172 | OH | Practitioner - Internal Medicine |
6406987593 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35070029H | OH | MD | Internal Medicine Physician |
| 35-070029 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orrville Hospital Foundation | Current |
Accepting new patients | |
| Orrville Hospital Foundation | Current |
Accepting new patients | |
| Orrville Hospital Foundation | Past | Accepting new patients | |
| Orrville Hospital Foundation | Past | Accepting new patients |
Locations
10724 State Route 212 NE
Bolivar, OH 44612
Phone (330) 874-7165
2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180
832 S Main St
Orrville, OH 44667
Phone (330) 456-2695
Interoperability endpoints
- matthew.hiestand@direct.aultman.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35070029H | OH | Yes |
| Pediatrics Physician | 208000000X | 35-070029 | OH |
Addresses
Primary practice location
10724 State Route 212 NE
Bolivar, OH 44612-8740
Mailing address
6046 Whipple Ave NW
North Canton, OH 44720-7616
Phone (330) 874-7165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2066473 | Medicaid | OH |
Other providers in Bolivar, OH
- Kelly Anne Farrell
- Mary Fouts
- Elena K Gonzalez-Abreu
- Jessica Heitman
- Aubrey Held
- Mark Andrew Hillyer
- Horizons of Tuscarawas and Carroll Counties, Inc.
- Allison R. Hupp
- Gabrielle Laux
- Megco Management Co.
All providers in Bolivar, OH · Internal Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.