Individual provider Active NPI

Matthew Brent Campbell, M.D.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1790981025
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-10675 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 322-1730
Fax
(208) 322-8996
NPI assigned
Jun 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD183879 OR
Emergency Medicine Physician 207P00000X M-10675 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

2963 E Copper Point Dr
Meridian, ID 83642-9055
Phone (208) 322-1730

Other practice location 1

1000 State St
McCall, ID 83638-3704
Phone (208) 634-2221

Other identifiers 1

IdentifierTypeStateIssuer
808371000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090818000855 ID Practitioner - Emergency Medicine 7012073679 Reassigns benefits to 2 organizations
I20171103000800 OR Practitioner - Emergency Medicine 7012073679 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, shared by 18 NPIs, 995 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Aug 1, 2022 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Aug 1, 2022 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
St Lukes Clinic - McCall LLC Emergency Medicine CurrentSince Aug 9, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1000 State St
McCall, ID 83638
Phone (208) 634-2221

211 W Forest St
McCall, ID 83638
Phone (208) 467-7546

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: mcampbell1563841@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 9

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": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1790981025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 E COPPER POINT DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429055",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-322-1730",
            "fax_number": "208-322-8996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 State St",
            "address_purpose": "LOCATION",
            "city": "McCall",
            "state": "ID",
            "postal_code": "836383704",
            "country_code": "US",
            "telephone_number": "208-634-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "MATTHEW",
        "middle_name": "BRENT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-24",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD183879",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-10675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808371000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.