Matthew Steven Nienberg, PA
Physician Assistant in Fremont, OH. Individual provider (NPI-1).
NPI number1063661189
StatusActive
Last updated in NPPESNov 22, 2019
Details
- NPI
- 1063661189
- Entity type
- Individual (NPI-1)
- Name
- Matthew Steven Nienberg
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 12, 2008
- Last updated
- Nov 22, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 50.002810 | OH | Yes |
Practice location
715 S Taft AveFremont, OH 43420-3237
Phone 419-334-6639 · Fax 419-333-2793
Mailing address
715 S Taft AveFremont, OH 43420-3237
Phone 419-334-6661 · Fax 419-334-6685
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physician Assistant providers in Fremont, OH
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 10 free a day, then credits from $29 for 5,000. Useful for credentialing, billing and pharmacy claim checks.