NPIMap

Individual provider Active NPI

Shane Michael Matheny, D.O.

  • Cardiovascular Disease Physician
  • Pickerington, OH
National Provider Identifier
1831301548
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34.010046 Issued in OH
Practice address
1010 Refugee Rd Ste 310
Pickerington, OH 43147-9653
Phone
(614) 788-4390
Fax
(614) 788-4399
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101016514 MI
Cardiovascular Disease Physician 207RC0000X 34.010046 OH Primary

Addresses

Primary practice location

1010 Refugee Rd Ste 310
Pickerington, OH 43147-9653

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
0051286MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110714000672 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5597933762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

765 N Hamilton Rd
Suite 120
Gahanna, OH 43230-8707
Phone (614) 533-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016514MIMDInternal Medicine Physician
34.010046OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC Internal Medicine CurrentSince Jun 23, 2011 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2019 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2019 Accepting new patients
Ohiohealth Corporation Internal Medicine CurrentSince Nov 17, 2019 Accepting new patients

Locations

869 N Bridge St
Chillicothe, OH 45601
Phone (740) 474-5024

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

765 N Hamilton Rd
Ste 120
Gahanna, OH 43230

1010 Refugee Rd
Ste 310
Pickerington, OH 43147
Phone (614) 544-9670

1030 Refugee Rd
Ste 280
Pickerington, OH 43147
Phone (614) 788-4390

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 4

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 6

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1831301548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 REFUGEE RD STE 310",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479653",
            "telephone_number": "614-788-4390",
            "fax_number": "614-788-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHENY",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016514",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34.010046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051286",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

Verify at the official NPI Registry.