Active NPI
Matthew Louis Klug, DO
- Internal Medicine Physician
- Corvallis, OR
National Provider Identifier
1578026621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 193998
- Practice address
- 3600 NW Samaritan Dr
Corvallis, OR 97330-3737 - Phone
- (541) 768-4906
- NPI assigned
- Apr 6, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 193998 | OR | Primary |
Addresses
Primary practice location
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Mailing address
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Lincoln Memorial University Medical Department, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 Kingsley LN
Norfolk, VA 23505-4602
Phone (757) 398-2673
3636 High St
Portsmouth, VA 23707-3236
Phone (757) 398-2222
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193998 | OR | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Current | Accepting new patients | |
| Bon Secours Medical Group Hampton Roads Specialty Care LLC | Current | Accepting new patients |
Locations
150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944
Interoperability endpoints
- mklug166248@samhealth.direct-ci.com
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.
-
- Cardiovascular Disease Physician
- Richmond, VA
- NPI 1629637475
-
- Durable Medical Equipment & Medical Supplies
- Franklin, VA
- NPI 1205451028
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portsmouth, VA
- NPI 1750399192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554508800000",
"number": "1578026621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-768-4906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 NW SAMARITAN DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303737",
"telephone_number": "541-768-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUG",
"first_name": "MATTHEW",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-06",
"last_updated": "2019-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "193998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2019; 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.
- 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.