Individual provider Active NPI

Gene E Dematteo, D.C.

  • Nutrition Chiropractor
  • Beverly, MA
National Provider Identifier
1023086097
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH 1698 Issued in MA
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

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
1698MAMDClinical Psychologist
CH 1698MAMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.