Individual provider Active NPI

Paul Michael Matus, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Oberlin, OH
National Provider Identifier
1861551269
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
35040908 Issued in OH
Practice address
90 Fairway Dr
Oberlin, OH 44074-1420
Phone
(440) 774-1929
Fax
(440) 774-1929
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 35040908 OH Primary

Addresses

Primary practice location

90 Fairway Dr
Oberlin, OH 44074-1420

Mailing address

90 Fairway Dr.
Oberlin, OH 44074
Phone (440) 774-1929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35040908OHMDEmergency Medical Services (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861551269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 FAIRWAY DR.",
            "city": "OBERLIN",
            "state": "OH",
            "postal_code": "44074",
            "telephone_number": "440-774-1929",
            "fax_number": "440-774-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 FAIRWAY DR",
            "city": "OBERLIN",
            "state": "OH",
            "postal_code": "440741420",
            "telephone_number": "440-774-1929",
            "fax_number": "440-774-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUS",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OH",
            "license": "35040908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oberlin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.