Matthew David Pavlick, D.D.S., M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

35-097190 Issued in OH

Practice address

1551 S Water St
Kent, OH 44240-4441

Phone

(330) 678-6564

Fax

(330) 676-6973

NPI assigned

Sep 30, 2009

Last updated

Oct 6, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mpavlick37888@ehrdirect.uhhospitals.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS. Pavlick and Reppas, Inc.

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Hudson, OH
  • NPI 1942489570

  Oral & Maxillofacial Surgery

  NPD (past) Authorized official

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1568796191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 S WATER ST",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404441",
            "telephone_number": "330-678-6564",
            "fax_number": "330-676-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 S WATER ST",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404441",
            "telephone_number": "330-678-6564",
            "fax_number": "330-676-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLICK",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-30",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-023385",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "35-097190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul A. Pathadan, M.D.
• Paths to Independence, Inc. (Paths to Independence - Vine)
• Nakia Dawanna Patterson
• Paula Hartman-Stein (Center for Healthy Aging)
• Danielle Paull
• Wendy Pease
• Kimberly Sue Peer, ED.D., ATC, LAT
• Michael James Pellicane
• Joseph Pendleton
• David Austin Penglase, BACHELORS

• Oral & Maxillofacial Surgery (D.M.D.) in Kent, OH
• Providers in Kent, OH by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.