Matthew Jason Ballew, DO
Individual provider Active NPI Family Medicine Physician · Biloxi, MS
NPI 1932720109 · NPPES record last updated Aug 11, 2023
Key facts
- NPI
- 1932720109
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0102206812 (VA)
- Practice address
- 301 Fisher St
Biloxi, MS 39534-2508 - Phone
- (228) 376-2273
- NPI assigned
- Apr 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 60
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of New England, College of Osteo Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital at Gulfport
Practice addresses (Care Compare)
1340 Broad Ave
Gulfport, MS 39501-2460
1340 Broad Ave
Gulfport, MS 39501-2465
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152
Hospital & facility affiliations
- Memorial Hospital at Gulfport
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- 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 |
|---|---|---|---|---|
| I20250731000150 | MS | Practitioner - Family Practice | 4385041326 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206812 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Family Medicine | Current |
Accepting new patients |
| Memorial Hospital at Gulfport | Single Specialty | Current | Accepting new patients |
| Memorial Hospital at Gulfport | Single Specialty | Current |
Accepting new patients |
Locations
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 0102206812 | VA | Yes |
Addresses
Primary practice location
301 Fisher St
Biloxi, MS 39534-2508
Mailing address
301 Fisher St
Biloxi, MS 39534-2508
Phone (228) 376-0440
Other providers in Biloxi, MS
- Rainna P Bahadur
- Caroline Baiady
- Austin Michael Bailey
- John Thomas Bailey
- Chelsea Irene Baisden
- Balto Health LLC
- Balto Health LLC
- Shavon Kypher Banks
- Sarah Catherine Bankston
- Gregory Bernard Baquet
All providers in Biloxi, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2023. 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.