Matthew A Braniecki, D.O.
Individual provider Active NPI Family Medicine Physician · Port Clinton, OH
NPI 1992062012 · NPPES record last updated Aug 16, 2019
Key facts
- NPI
- 1992062012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34011656 (OH)
- Practice address
- 3960 E Harbor Rd
Port Clinton, OH 43452-2670 - Phone
- (419) 732-0700
- Fax
- (419) 732-0702
- NPI assigned
- Apr 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 27
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Health Services of Erie County
North Coast Professional Company, LLC
Practice addresses (Care Compare)
1912 Hayes Ave
Suite D
Sandusky, OH 44870-4736
Phone (419) 502-2800
3960 E Harbor Rd
Port Clinton, OH 43452-2670
Phone (419) 732-0700
Hospital & facility affiliations
- Ohioans Home Healthcare, Inc
- FRMC Home Health Services
- Firelands Regional Medical Center
- Magruder Hospital
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 |
|---|---|---|---|---|
| I20150717001823 | OH | Practitioner - Family Practice | 1557674611 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
Locations (25 of 26)
20 Center St
Berlin Heights, OH 44814
Phone (419) 499-3000
207 Lowell St
Rm 212
Castalia, OH 44824
209 Lowell St
Ste 213
Castalia, OH 44824
3851 US Hwy 20
Collins, OH 44826
1 University Dr
Rm 112B
Huron, OH 44839
710 Cleveland Rd W
Huron, OH 44839
2603 State Route 113 E
Milan, OH 44846
Phone (419) 499-3000
140 S Main St
Milan, OH 44846
Phone (419) 499-2471
101 West St
Rm 340
Monroeville, OH 44847
265 Benedict Ave
Norwalk, OH 44857
Phone (419) 219-9776
3960 East Harbor Rd
Port Clinton, OH 43452
Phone (419) 557-5488
3960 E Harbor Light Landing Dr
Port Clinton, OH 43452
Phone (419) 732-0700
1031 Pierce St
Ste D
Sandusky, OH 44870
1912 Hayes Ave
Ste E
Sandusky, OH 44870
1912 Hayes Ave
Sandusky, OH 44870
Phone (419) 609-1460
2314 Hancock St
Sandusky, OH 44870
703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785
2020 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-1236
2130 Hayes Ave
#A
Sandusky, OH 44870
2130 Hayes Ave
Ste A
Sandusky, OH 44870
1912 Hayes Ave
Ste D
Sandusky, OH 44870
Phone (419) 502-4800
125 E Adams St
Sandusky, OH 44870
620 E Water St
Ste A
Sandusky, OH 44870
Phone (419) 502-2829
149 E Water St
Sandusky, OH 44870
Phone (419) 625-0925
2130 Hayes Ave
Sandusky, OH 44870
Phone (419) 984-1081
Interoperability endpoints
- matthew.braniecki@fpg.medicity.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 34011656 | OH | Yes |
Addresses
Primary practice location
3960 E Harbor Rd
Port Clinton, OH 43452-2670
Mailing address
1031 Pierce St
Suite D
Sandusky, OH 44870-4669
Phone (419) 557-5568
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0121443 | Medicaid | OH |
Other providers in Port Clinton, OH
- Rejina K Blair
- Shelby Ann Blymyer
- Autumn Bodi
- David Andrew Bodie
- Brittani Bonanno
- Brideget N Urban DC LLC
- Katherine Brink
- Marshall Brink
- Ashley Marie Broshious
- Amber Dessarae Brown
All providers in Port Clinton, 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 Aug 16, 2019. 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.