NPIMap

Individual provider Active NPI

Matthew Bernard Pawlicki, MD

  • Family Medicine Physician
  • Chardon, OH
National Provider Identifier
1619978384
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-839943 Issued in OH
Practice address
100 Seventh Ave Ste 111
Chardon, OH 44024-7802
Phone
(440) 286-8841
Fax
(440) 286-8867
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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 35-839943 OH Primary

Addresses

Primary practice location

100 Seventh Ave Ste 111
Chardon, OH 44024-7802

Mailing address

24701 Euclid Ave
Third Floor Billing Services
Euclid, OH 44117-1714
Phone (440) 286-8841

Other identifiers 2

IdentifierTypeStateIssuer
2499872MedicaidOH
83994OtherOHSTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address matthewpawlicki@uhps.allscriptsdirect.net
Direct Messaging Address matthewpawlicki@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901001031 OH Practitioner - Family Practice 0446225437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Hospitals Regional Practices LLCGroup PAC ID 3779818638, 26 clinicians

Practice addresses (Care Compare)

100 7TH Ave
Suite 111
Chardon, OH 44024-7802
Phone (440) 286-8841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.24 of 100Reported as group
Quality
62.05
Promoting interoperability
100
Improvement activities
40
Cost
73.19

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-839943OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Regional Practices LLC Family Medicine CurrentSince Jul 21, 2019 Accepting new patients
All Caring Hospice, LLC Family Medicine CurrentSince Mar 20, 2021 Accepting new patients
Briar Hill Health Care Residence Inc Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients
Huntsburg Healthcare Community, LLC Past Accepting new patients
Fairmount Nursing Home Inc Past Accepting new patients
University Primary Care Practices Inc Family Medicine Past Accepting new patients
Blossom Hill Care Center Inc Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Locations

6715 Tippecanoe Rd
Ste B101
Canfield, OH 44406
Phone (330) 286-3435

100 7th Ave
Ste 111
Chardon, OH 44024
Phone (440) 286-8841

8055 Mayfield Rd
Ste 107
Chesterland, OH 44026
Phone (440) 729-3644

8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024

15976 E High St
Ste 100
Middlefield, OH 44062
Phone (440) 632-0770

321 Norristown Rd
Ste 250
Ambler, PA 19002

Interoperability endpoints

  • Direct secure messaging: mpawlicki37166@ehrdirect.uhhospitals.org

Organizations & group practices 9

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1619978384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "THIRD FLOOR BILLING SERVICES",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "440-286-8841",
            "fax_number": "440-286-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SEVENTH AVE STE 111",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247802",
            "telephone_number": "440-286-8841",
            "fax_number": "440-286-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLICKI",
        "first_name": "MATTHEW",
        "middle_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2020-12-30",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-839943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2499872",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "83994",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthewpawlicki@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "100 Seventh Ave Ste 111",
            "city": "Chardon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440247802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthewpawlicki@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "100 Seventh Ave Ste 111",
            "city": "Chardon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440247802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.