Active NPI
Gene E Dematteo, D.C.
- Nutrition Chiropractor
- Beverly, MA
National Provider Identifier
1023086097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- CH 1698
- Practice address
- 38 Enon St
Suite 4
Beverly, MA 01915-1139 - Phone
- (978) 922-8778
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | CH 1698 | MA | Primary |
Addresses
Primary practice location
38 Enon St
Suite 4
Beverly, MA 01915-1139
Mailing address
PO Box 61
Beverly, MA 01915-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120412000620 | MA | Practitioner - Chiropractic | 3577724848 | Practice locations: Beverly, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
38 R Enon St
Suite 1
Beverly, MA 01915-1167
Phone (978) 922-8778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1698 | MA | MD | Clinical Psychologist |
| CH 1698 | MA | MD | Nutrition Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine Associates P. C. | Past | Accepting new patients | |
| Beth Israel Lahey Health Specialty Care, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Gloucester, MA
- NPI 1235147760
-
- Primary Care Clinic/Center
- Beverly, MA
- NPI 1508864828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1023086097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 61",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019150001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 ENON ST",
"address_2": "SUITE 4",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019151139",
"telephone_number": "978-922-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMATTEO",
"first_name": "GENE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "MA",
"license": "CH 1698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.