Matthew A Kienstra, MD

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

2006003278 Issued in MO

Practice address

1965 S Fremont Ave
Suite 120
Springfield, MO 65804-2201

Phone

(417) 887-3223

Fax

(417) 820-3955

NPI assigned

Feb 6, 2007

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

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

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Southern Illinois University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkienstra18435@directc.mercy.net
• Direct secure messaging: mkienstra912@directb.mercy.net

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.

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD
• University Medical Service Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1194276576
  NPD (past)

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

• Mercy Hospital Springfield

  • Air Ambulance
  • Branson West, MO
  • NPI 1144430760

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Mount Vernon, MO
  • NPI 1427279173

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Camdenton, MO
  • NPI 1477765204

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Winona, MO
  • NPI 1538380654

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Stockton, MO
  • NPI 1558573386

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Springfield, MO
  • NPI 1558573410

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1578504056
  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Mountain View, MO
  • NPI 1639204308

  Hospital

  Care Compare affiliation
• Mercy Hospital Springfield

  • Land Ambulance
  • Green Forest, AR
  • NPI 1477756609

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1740329671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE",
            "address_2": "SUITE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042201",
            "telephone_number": "417-887-3223",
            "fax_number": "417-820-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENSTRA",
        "first_name": "MATTHEW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2006003278",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MO",
            "license": "2006003278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160592001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200586204",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE SHIELD",
            "identifier": "204558",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BLUE SHIELD",
            "identifier": "83878",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Robert Kickham, OD
• Alisha Jade Kidd
• Paul Michael Kidder, D.O.
• Kids Care Pediatric Therapies
• Benjamin Kienenberger
• Kristen D Kiersey, FNP
• Jessica Leanne Kifer, PHARMD
• Olivia M. Kilburn, CRNA
• Kate P. Kilgo, FNP
• Lindsay N Killam, PLPC

• Facial Plastic Surgery Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Facial Plastic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
• 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.