Individual provider Active NPI

Jason Ross Mattingly, M.D.

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1548267826
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35085748 Issued in OH
Practice address
3301 Mercy Boulevard
Suite 340
Cincinnati, OH 45211-1112
Phone
(513) 981-5922
Fax
(513) 385-6430
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35085748 OH Primary

Addresses

Primary practice location

3301 Mercy Boulevard
Suite 340
Cincinnati, OH 45211-1112

Mailing address

3301 Mercy Boulevard
Suite 340
Cincinnati, OH 45211-1112
Phone (513) 981-5922

Other identifiers 1

IdentifierTypeStateIssuer
2552090MedicaidOH

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
I20050427001431 OH Practitioner - Family PracticePractitioner - General Practice 8527007699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians

Practice addresses (Care Compare)

3301 Mercy Health Blvd
Suite 125
Cincinnati, OH 45211-1106
Phone (513) 215-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085748OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati LLC CurrentSince Feb 1, 2011 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Family Medicine CurrentSince Feb 1, 2011 Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

3301 Mercy Health Blvd
Ste 125
Cincinnati, OH 45211
Phone (513) 215-9200

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

3301 Mercy Health Blvd
Ste 340
Cincinnati, OH 45211
Phone (513) 686-2663

Interoperability endpoints

  • Direct secure messaging: jmattingly26438@direct.bsmhealth.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 5

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1548267826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 MERCY BOULEVARD",
            "address_2": "SUITE 340",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452111112",
            "telephone_number": "513-981-5922",
            "fax_number": "513-385-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 MERCY BOULEVARD",
            "address_2": "SUITE 340",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452111112",
            "telephone_number": "513-981-5922",
            "fax_number": "513-385-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "JASON",
        "middle_name": "ROSS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35085748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2552090",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.