LYDIA C. SAMPLES MATTISON (M.D.) – Family Medicine Physician, NPI 1184670325
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,718 FAMILY PRACTICE in KY
Provider Addresses for LYDIA C. SAMPLES MATTISON (M.D.)
5100 Outer Loop
Louisville, KY 402194056
Phone: (502) 968-6226
Fax: (502) 966-5562
Type: Location
4350 Hamilton Cleves Rd
Cleves, OH 45002
Phone: (513) 215-6400
Fax: (513) 215-6401
Type: Location
6101 BLUE LAGOON DR STE 200
MIAMI, FL 331263168
Phone:
Type: Mailing
601 VERSAILLES RD
FRANKFORT, KY 406013857
Phone: (502) 695-3946
Type: Location
Hamilton Cleves Road, Cleves, Miami Township, Hamilton County, Ohio, 45052, United States
CLEVES, OH 450029343
Phone: (513) 215-6400
Fax: (513) 215-6401
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050105000203 | I | Family Practice | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 40219)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OH | |
| Orthopedic Surgery | OH | |
| Internal Medicine | OH | |
| Orthopedic Surgery | KY | |
| Orthopedic Surgery, Sports Medicine | KY | |
| Sports Medicine, Family Practice, Family Practice, Sports Medicine | KY | |
| Family Practice | IL | |
| Pain Management, Anesthesiology, Interventional Pain Management | KY | |
| Orthopedic Surgery | KY | |
| Family Practice, Gastroenterology | KY |
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