Matthew Christopher Dale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007385 Issued in OH

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-8400

NPI assigned

May 28, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

96.9 of 100Reported as group

Quality

91.17

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951
  Medicare reassignment
• Emergency Medicine Physicians of Cincinnati, LTD.

  • Emergency Medicine Physician
  • Cincinnati, OH
  • NPI 1922483213
  Medicare reassignment

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1700443512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4118 28TH ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091602",
            "telephone_number": "803-237-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007385",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise D Cunningham, LPN
• Shelly Christine Curtis, PHARM.D.
• Matthew Michael Cyphers, PHYSICIAN ASSISTANT
• Cameron Cyr
• Deborah R Dale, LPN
• John Page Dana, PHYSICIAN ASSISTANT
• Kelly Daniel, PTA
• Christy Bayless Daughtry, FNP-BC
• Sydney H Davidson, LCSW
• Kasey Davies

• Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.