Individual provider Active NPI

Matthew Patrick Olzak

  • Family Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1528613601
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LE-00028213 Issued in OH
Practice address
5700 Monroe St Unit 310
Sylvania, OH 43560-2768
Phone
(419) 578-7555
Fax
(419) 539-6336
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LE-00028213 OH Primary

Addresses

Primary practice location

5700 Monroe St Unit 310
Sylvania, OH 43560-2768

Mailing address

100 Madison Ave
Toledo, OH 43604-1516

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address molzak33987@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191025002665 OH Practitioner - Nurse Practitioner 7416289335 Reassigns benefits to 1 organization
I20200116002294 MI Practitioner - Nurse Practitioner 7416289335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-1111

718 N Macomb St
Monroe, MI 48162-7815
Phone (419) 240-8835

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LE-00028213OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Multi Specialty Physicians CurrentSince Feb 21, 2025 Accepting new patients

Locations

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

777 Kimole Ln
Ste 130
Adrian, MI 49221
Phone (517) 265-0292

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

5700 Monroe St
Unit 310
Sylvania, OH 43560
Phone (419) 578-7555

5308 Harroun Rd
Ste 55
Sylvania, OH 43560
Phone (419) 824-6599

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: molzak33987@direct.promedica.org

Organizations & group practices 2

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 2

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1528613601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE ST UNIT 310",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602768",
            "telephone_number": "419-578-7555",
            "fax_number": "419-539-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLZAK",
        "first_name": "MATTHEW",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "LE-00028213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "molzak33987@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.