Matthew M Keum, M.D., Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

35078037 Issued in OH

Legal business name

MATTHEW M KEUM, M.D., INC

Practice address

36060 Euclid Ave
Suite 101
Willoughby, OH 44094-4656

Phone

(440) 269-4990

Fax

(440) 269-4991

NPI assigned

Apr 23, 2012

Organization subpart

No

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

Authorized official

Name

Matthew M Keum, MDNPI 1073508297

Title

Ceo

Phone

(440) 269-4990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Minseok Keum, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Willoughby, OH
  • NPI 1073508297
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1518224906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36060 EUCLID AVE",
            "address_2": "SUITE 101",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944656",
            "telephone_number": "440-269-4990",
            "fax_number": "440-269-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36060 EUCLID AVE",
            "address_2": "SUITE 101",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944656",
            "telephone_number": "440-269-4990",
            "fax_number": "440-269-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW M KEUM, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "KEUM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-269-4990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OH",
            "license": "35078037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S. Martin
• Patricia Martinac
• John Robert Mascaro, DMD MD
• Ann Marie Mason, LICDC-CS
• Hallie Mastroianni
• Mary E Matzinger
• Shannon Mauk
• Max-Wellness, LLC
• Alana Maye
• Lydia Mayfield

• Pain Medicine Physician in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Pain Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.