Individual provider Active NPI

Kelsey Matarese

  • Massage Therapist
  • Mesa, AZ
National Provider Identifier
1003601741
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-25907 Issued in AZ
Practice address
4135 S Power Rd Ste 110
Mesa, AZ 85212-3625
Phone
(480) 299-2293
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT-25907 AZ Primary

Addresses

Primary practice location

4135 S Power Rd Ste 110
Mesa, AZ 85212-3625

Mailing address

1233 W 6TH Ave
Apache Junction, AZ 85120-6649
Phone (480) 299-2293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT-25907AZMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1003601741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 W 6TH AVE",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206649",
            "telephone_number": "480-299-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123625",
            "telephone_number": "480-299-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATARESE",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-25907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.