Matthew J Maccallum, D. O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

1940 Issued in WV

Practice address

333 Laidley St
Charleston, WV 25301-1614

Phone

(304) 344-0096

Fax

(304) 342-4725

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Anesthesiology

Education

West Virginia School of Osteopathic Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Virginia University Medical CorporationGroup PAC ID 1052224565, 1,974 clinicians

THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
• West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmaccallum363236@direct.wvuhsdirect.com

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.

• THS Physician Partners Inc

  • Internal Medicine Physician
  • South Charleston, WV
  • NPI 1871866806
  Medicare reassignment Care Compare group NPD
• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Professional Anesthesia Service,Inc.

  • Anesthesiology Physician
  • Charleston, WV
  • NPI 1720035827
  Medicare reassignment NPD
• West Virginia University Medical Corporation

  dba Crisis Support and Recovery Center

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• National Emergency Services West Virginia Inc

  • Emergency Medicine Physician
  • Petersburg, WV
  • NPI 1528480712
  NPD (past)

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

• Herbert J. Thomas Memorial Hospital Association

  dba Thomas Memorial Hospital

  • General Acute Care Hospital
  • South Charleston, WV
  • NPI 1316925506
  Care Compare affiliation
• West Virginia University Hospitals, Inc

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1841271459
  Care Compare affiliation

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1689718645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ROANE ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022334",
            "telephone_number": "304-344-0096",
            "fax_number": "304-342-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAIDLEY ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011614",
            "telephone_number": "304-344-0096",
            "fax_number": "304-342-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCALLUM",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "D. O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "1940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003403000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA4091223",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00426369",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Lyttle, RBT
• Justin Cole Lyttle, DMPNA CRNA
• Megan Maazaoui, LICSW - DP00945457
• Hunter Lee Mabe
• Brian Wayne Macaulay, MD
• Kathryn Macdonald, SUPPORTIVE COUNSELOR
• Allan Mace
• Georgina Katherin Mace
• Kristina Mace
• Tina Machuca

• Anesthesiology Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Anesthesiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.

Verify at the official NPI Registry.