Individual provider Active NPI

Mathew W Maccumber, MD

  • Retina Specialist (Ophthalmology) Physician
  • Harvey, IL
National Provider Identifier
1649270224
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
036093409 Issued in IL
Practice address
71 W 156TH St
Ste 400
Harvey, IL 60426-4265
Phone
(708) 596-8710
Fax
(708) 596-9820
NPI assigned
Jul 26, 2005
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036093409 IL
Retina Specialist (Ophthalmology) Physician 207WX0107X 036093409 IL Primary

Addresses

Primary practice location

71 W 156TH St
Ste 400
Harvey, IL 60426-4265

Mailing address

11516 183Rd PL Ste SW
Orland Park, IL 60467-9471
Phone (708) 877-1300

Other identifiers 2

IdentifierTypeStateIssuer
036093409MedicaidIL
180033953OtherILRRMC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmaccumber@illret.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20080325000213 IL Practitioner - Ophthalmology 0840299087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Johns Hopkins University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Center Physicians, LTD.Group PAC ID 2567411325, 36 clinicians
Illinois Retina Associates, PLLCGroup PAC ID 6709799810, 19 clinicians

Practice addresses (Care Compare)

1725 W Harrison St
Chicago, IL 60612-3848
Phone (312) 942-5315

71 W 156TH St
Suite 400
Harvey, IL 60426-4265
Phone (708) 596-8710

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Retina Associates PLLC Ophthalmology CurrentSince Oct 9, 2018 Accepting new patients
Eye Center Physicians, LTD. Ophthalmology CurrentSince Jan 1, 2007 Accepting new patients

Locations

1725 W Harrison St
Ste 906
Chicago, IL 60612
Phone (312) 733-7566

1725 W Harrison St
Ste 915
Chicago, IL 60612
Phone (312) 942-2117

2845 N Sheridan Rd
Ste 900
Chicago, IL 60657
Phone (773) 871-8444

331 W Surf St
Ste 900
Chicago, IL 60657

71 W 156th St
Ste 400
Harvey, IL 60426
Phone (708) 596-8710

300 Barney Dr
Ste D
Joliet, IL 60435
Phone (815) 744-7515

610 S Maple Ave
Ste 1700
Oak Park, IL 60304
Phone (708) 660-8450

610 S Maple Ave
Ste 4000
Oak Park, IL 60304
Phone (706) 660-6301

11516 183rd Pl
Ste Sw
Orland Park, IL 60467
Phone (708) 877-1300

4711 Golf Rd
Ste 102
Skokie, IL 60076
Phone (847) 677-1340

Interoperability endpoints

  • Direct secure messaging: mmaccumber@illret.intellechartdirect.net
  • Direct secure messaging: mmaccumber4038@direct.rush.rush-health.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1649270224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11516 183RD PL STE SW",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679471",
            "telephone_number": "708-877-1300",
            "fax_number": "708-596-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "STE 400",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264265",
            "telephone_number": "708-596-8710",
            "fax_number": "708-596-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCUMBER",
        "first_name": "MATHEW",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036093409",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036093409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093409",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "180033953",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaccumber@illret.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "71 W 156th St",
            "address_2": "Ste 400",
            "city": "Harvey",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604264265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.