Individual provider Active NPI

Matthew B McLellan, MD

  • Family Medicine Physician
  • Van Buren, AR
National Provider Identifier
1629095328
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-2581 Issued in AR
Practice address
2521 Alma Hwy
Van Buren, AR 72956-5015
Phone
(479) 274-6800
Fax
(479) 474-4513
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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 E-2581 AR Primary

Addresses

Primary practice location

2521 Alma Hwy
Van Buren, AR 72956-5015

Mailing address

PO Box 3528
Fort Smith, AR 72913-3528
Phone (479) 274-2000

Other identifiers 2

IdentifierTypeStateIssuer
141364001MedicaidAR
080158539OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20091215000148 AR Practitioner - Family Practice 4688714124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health ServicesGroup PAC ID 0648514133, 103 clinicians

Practice addresses (Care Compare)

1120 Lexington Ave
Fort Smith, AR 72901-5136
Phone (479) 709-7260

1500 Dodson Ave
Fort Smith, AR 72901-5182

3808 Gary St
Fort Smith, AR 72903-5450

Hospital & facility affiliations

  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-2581ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Services Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Baptist Health Services Current Accepting new patients

Locations

3808 Gary St
Ste B
Fort Smith, AR 72903
Phone (479) 709-7020

1500 Dodson Ave
Ste 285B
Fort Smith, AR 72901
Phone (479) 709-7025

1500 Dodson Ave
Ste 60
Fort Smith, AR 72901
Phone (479) 709-7325

1120 Lexington Ave
Fort Smith, AR 72901
Phone (479) 709-7260

1500 Dodson Ave
Fort Smith, AR 72901
Phone (479) 441-2600

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

2521 Alma Hwy
Van Buren, AR 72956
Phone (479) 474-7448

Interoperability endpoints

  • Direct secure messaging: mmclellan218179@direct.baptist-healthar.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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1629095328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3528",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729133528",
            "telephone_number": "479-274-2000",
            "fax_number": "479-274-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 ALMA HWY",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565015",
            "telephone_number": "479-274-6800",
            "fax_number": "479-474-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLELLAN",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-2581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141364001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080158539",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

Verify at the official NPI Registry.