DR. MATTHEW BIRKLE MD
NPI 1427052075
Emergency Medicine in Cincinnati, OH
NPI Status: Active since June 10, 2005
Contact Information
6139 GLENWAY AVE
CINCINNATI, OH
ZIP 45211
Phone: (513) 346-3399
Fax: (513) 852-1467
- Individual
- Male
- Emergency Medicine
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About MATTHEW BIRKLE
This page provides the complete NPI Profile along with additional information for Matthew Birkle, a provider established in Cincinnati, Ohio with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1427052075 assigned on June 2005. The practitioner's primary taxonomy code is 207P00000X with license number 35069240 (OH). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1427052075
- Provider Name
- DR. MATTHEW BIRKLE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 6139 GLENWAY AVE CINCINNATI, OH 45211
- Location Phone
- (513) 346-3399
- Location Fax
- (513) 852-1467
- Mailing Address
- 6739 STATE ROUTE 128 P.O BOX 189 MIAMITOWN, OH 45041
- Mailing Phone
- (513) 923-2623
- Mailing Fax
- (513) 852-1467
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-10-2005
- Last Update Date
- 11-27-2023
- Code Navigator
Location Map
Secondary Locations
- 7910 E Washington St Ste 110
Indianapolis, IN 46219
(317) 355-3201
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 35069240
- License State
- OH
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | 01059348A (IN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Pathway X HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 8500/50%/9200 - HMO
- Anthem Gold Pathway X HMO 1000/20%/7500 - HMO
- Anthem Gold Pathway X HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Pathway X HMO 2000/10%/4600 w/HSA - HMO
- Bronze First 7500 $25 Generic Drugs - HMO
- Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
- Core Gold 1500 $10 Generic Drugs - HMO
- Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
- Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
- Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Gold 1500 $15 Generic Drugs - HMO
- Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
- HDHP Preventive Silver 5500 $0 Select Drugs - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
- Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
- Low Premium Silver 6000 $3 Generic Drugs - HMO
- Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
- Silver 5000 $20 Generic Drugs - HMO
- Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200219210 | MEDICAID (05) | IN | |
| 300030867 | MEDICAID (05) | IN | |
| 64074990 | MEDICAID (05) | KY | |
| 0230913 | MEDICAID (05) | OH |
Medicare Participation & PECOS Enrollment Status
Matthew Birkle is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 45211 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.72
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.65
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.44
- Minimum Established Patient Price $17.1
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $24.11
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Pneumococcal Vaccination Status for Older Adults | 51% | 170 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
Reviews for DR. MATTHEW BIRKLE MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 0 | 5 | 2 | 0 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 0 | 5 | 4 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 0 + 5 + 4 + 0 + 1 + 4 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1427052075 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1689928889 | TRIHEALTH PHYSICIAN PRACTICES LLC Organization | Family Medicine | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 569-6380 |
| 1063581999 | DEBORAH A FARIS PA-C Individual | Physician Assistant | 6139 GLENWAY AVE MEDICAL DEPARTMENT CINCINNATI, OH 45211 (513) 346-3399 |
| 1699293548 | MRS. DANIELLE HARLOW RN Individual | Nurse Practitioner (Family) | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 346-3399 |
| 1255737433 | MARY ANNE ADAMS RN, APN Individual | Nurse Practitioner (Family) | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 346-3399 |
| 1205401270 | MS. SAMANTHA ELAINE WIESNER APRN, FNP-C Individual | Nurse Practitioner (Family) | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 346-3399 |
| 1174018972 | MIRAL N PATEL CNP Individual | Nurse Practitioner (Family) | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 346-3399 |
| 1043684335 | ARLAINA M DUNNING CNP Individual | Nurse Practitioner (Family) | 6139 GLENWAY AVE CINCINNATI, OH 45211 (513) 346-3399 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427052075, enumerated in the NPI registry as an "individual" on June 10, 2005
The provider is located at 6139 Glenway Ave Cincinnati, Oh 45211 and the phone number is (513) 346-3399
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $84.72 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on June 10, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.