NPIMap

Individual provider Active NPI

Matthew Maxwell Kellogg, MD

  • Anesthesiology Physician
  • Corvallis, OR
National Provider Identifier
1932151990
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD26009 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone
(541) 757-5111
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD26009 OR Primary

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-5472

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Other practice location 1

707 SW Washington St
Ste 700
Portland, OR 97205-3536
Phone (503) 299-9906

Other identifiers 3

IdentifierTypeStateIssuer
213509MedicaidOR
8429359MedicaidWA
P00412469OtherORRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkellogg266647@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20050802001239 OR Practitioner - Anesthesiology 3274561089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nevada School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince Jul 15, 2023 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Jul 15, 2023 Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Jul 1, 2005 Accepting new patients

Locations

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

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 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1932151990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305472",
            "telephone_number": "541-757-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 SW Washington St",
            "address_2": "Ste 700",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972053536",
            "country_code": "US",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "MATTHEW",
        "middle_name": "MAXWELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD26009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213509",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8429359",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00412469",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkellogg266647@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973305472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.