Active NPI
Matthew R Pittman, M.D.
- Surgery Physician
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036138487
- Practice address
- 4830 Knightsbridge Blvd
Suite J
Columbus, OH 43214-2300 - Phone
- (614) 293-3230
- Fax
- (614) 293-4030
- NPI assigned
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125.055834 | IL | |
| Surgery Physician | 208600000X | 35123279 | OH | |
| Surgery Physician | 208600000X | 036138487 | IL | Primary |
Addresses
Primary practice location
4830 Knightsbridge Blvd
Suite J
Columbus, OH 43214-2300
Mailing address
351 Delnor Dr
Geneva, IL 60134-4222
Phone (630) 668-0833
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0104249 | Medicaid | OK | |
| 206147 | Other | IL | MEDICARE PTAN GROUP |
| F400237729 | Other | IL | MEDICARE PTAN INDIVIDUAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Georgetown University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800
25 N Winfield Rd
Winfield, IL 60190-1295
300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700
304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799
Hospital & facility affiliations
- Northwestern Medicine Delnor Community Hospital
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine Kishwaukee Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 13 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036138487 | IL | MD | Surgery Physician |
| 125.055834 | IL | MD | Surgery Physician |
| 35123279 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Carol Stream, IL 60122
Phone (630) 933-3300
Dept 5777
Carol Stream, IL 60122
300 Randall Rd
Ste 100
Geneva, IL 60134
Phone (630) 933-3513
351 Delnor Dr
Ste 400
Geneva, IL 60134
Phone (630) 232-2885
351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
25 N Winfield Rd
#410
Winfield, IL 60190
Phone (630) 293-4326
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
-
- General Acute Care Hospital
- Dekalb, IL
- NPI 1669534517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442448000000",
"number": "1861621633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 DELNOR DR",
"city": "GENEVA",
"state": "IL",
"postal_code": "601344222",
"telephone_number": "630-668-0833",
"fax_number": "630-667-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4830 KNIGHTSBRIDGE BLVD",
"address_2": "SUITE J",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432142300",
"telephone_number": "614-293-3230",
"fax_number": "614-293-4030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTMAN",
"first_name": "MATTHEW",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2015-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125.055834",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35123279",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036138487",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0104249",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN GROUP",
"identifier": "206147",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN INDIVIDUAL",
"identifier": "F400237729",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.