Matthew Jesse Bambino, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OT023699 Issued in PA

Practice address

5515 Peach St
Erie, PA 16509-2695

Phone

(814) 864-4031

NPI assigned

Jun 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1740021880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 HOMEVIEW LN APT 108",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165094375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092695",
            "telephone_number": "814-864-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBINO",
        "first_name": "MATTHEW",
        "middle_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT023699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Ballarin, M.D.
• Gregory Bruce Ballengee, MD
• Jason P Balogh, PT
• Katelyn Marie Balogh
• Michael Balsan
• Jennifer Rose Banak, LCSW
• Kelsey Ann Baney, M.S., CCC-SLP
• Craig Baniszewski, D.C.
• Caley Banko
• Brian Joseph Bansidhar, D.O.

• Family Medicine Physician in Erie, PA
• Providers in Erie, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.