NPIMap

Individual provider Active NPI

Matthew C Riesen, MD

  • General Practice Physician
  • Saint Marys, OH
National Provider Identifier
1497947998
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
35. 099958 Issued in OH
Practice address
1132 Hager St
Saint Marys, OH 45885-2423
Phone
(419) 394-5851
Fax
(419) 394-0702
NPI assigned
Aug 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 35. 099958 OH Primary

Addresses

Primary practice location

1132 Hager St
Saint Marys, OH 45885-2423

Mailing address

1132 Hager St
#600
Saint Marys, OH 45885-2423
Phone (419) 394-5851

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
I20130327000067 OH Practitioner - General Practice 7810132685 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Toledo Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercer County Joint Township Community HospitalGroup PAC ID 8820081755, 60 clinicians

Practice addresses (Care Compare)

1132 Hager St
Saint Marys, OH 45885-2423
Phone (419) 394-5851

950 S Main St
Celina, OH 45822-2413
Phone (419) 586-1611

Hospital & facility affiliations

  • Community Health Professionals, Inc Home health agency, Van Wert, OH, CCN 367131
  • Grand Lake Home Health Home health agency, St Marys, OH, CCN 367405
  • Grand Lake Hospice Hospice, Saint Marys, OH, CCN 361636
  • Grand Lake Health System Hospital, Saint Marys, OH, CCN 360032
  • Mercer County Joint Township Community Hospital Hospital, Coldwater, OH, CCN 360058
  • Lima Memorial Health System Hospital, Lima, OH, CCN 360009
  • Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
  • Otterbein St Marys Retirement Community Nursing home, St Marys, OH, CCN 365953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35. 099958OHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions, LLC CurrentSince Apr 29, 2014 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince Nov 1, 2015 Accepting new patients
St Marys Medical Group Inc. CurrentSince Apr 1, 2013 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince Nov 1, 2015 Accepting new patients
Incare Health Solutions LLC CurrentSince Apr 29, 2014 Accepting new patients
Diagnostic Pathology, LLC Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

950 S Main St
Celina, OH 45822
Phone (419) 586-1611

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

1132 Hager St
Saint Marys, OH 45885
Phone (419) 394-5851

1132 Hager St
#600
Saint Marys, OH 45885

Organizations & group practices 7

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 10

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": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1497947998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 HAGER ST",
            "address_2": "#600",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852423",
            "telephone_number": "419-394-5851",
            "fax_number": "419-394-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 HAGER ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852423",
            "telephone_number": "419-394-5851",
            "fax_number": "419-394-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESEN",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35. 099958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, OH

Sources for this page

Verify at the official NPI Registry.