Matthew L Oconnell, MD
Individual provider Active NPI Family Medicine Physician · Centerville, OH
NPI 1891750600 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1891750600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 35056112O (OH)
- Practice address
- 979 Congress Park Drive
Centerville, OH 45459-4009 - Phone
- (937) 435-9013
- Fax
- (937) 435-9013
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Wright State University Boonshoft School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alliance Physicians Inc
Practice addresses (Care Compare)
1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534
7700 Washington Village Dr
Centerville, OH 45459-4094
Hospital & facility affiliations
- Miami Valley Hospital
- Kettering Health Main Campus
- Kettering Health Dayton
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100322000037 | OH | Practitioner - Family Practice | 8426042797 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35056112O | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Physicians Inc | Family Medicine | Current |
Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891
979 Congress Park Dr
Dayton, OH 45459
Phone (937) 435-9013
540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
243 W Central Ave
Springboro, OH 45066
Phone (513) 748-4814
7700 Washington Village Dr
Ste 260
Washington Township, OH 45459
Phone (937) 435-9013
1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534
1141 N Monroe Dr
Xenia, OH 45385
Phone (937) 352-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35056112O | OH | Yes |
Addresses
Primary practice location
979 Congress Park Drive
Centerville, OH 45459-4009
Mailing address
7700 Washington Village Dr Ste 260
Dayton, OH 45459-4097
Phone (937) 435-9013
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0747375 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | moconnell188593@direct.ketteringhealth.org |
Other providers in Centerville, OH
- Douglas Nyakundi
- Patrick Thomas O'Bryan
- Sara O'Connell
- Oak Creek OB GYN Inc
- Obg Associates Inc.
- Ohio Allergy Associates, Inc.
- Ohio Psychological Testing, LLC
- Ohio Wound and Hyperbaric Center, LLC
- Rebekah Oladokun
- Ooh Care of Oh, LLC
All providers in Centerville, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.