Individual provider Active NPI

Michael D. Mathey, D.C.

  • Chiropractor
  • Redlands, CA
National Provider Identifier
1063400455
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23478 Issued in CA
Practice address
334 Brookside Ave
Redlands, CA 92373-4608
Phone
(909) 793-3994
Fax
(909) 793-9374
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23478 CA Primary

Addresses

Primary practice location

334 Brookside Ave
Redlands, CA 92373-4608

Mailing address

334 Brookside Ave
Redlands, CA 92373-4608
Phone (909) 793-3994

Other identifiers 1

IdentifierTypeStateIssuer
DC0234780MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000550 CA Practitioner - Chiropractic 2567639412 Practice locations: Redlands, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

334 Brookside Ave
Redlands, CA 92373-4608
Phone (909) 793-3994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC23478CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1063400455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734608",
            "telephone_number": "909-793-3994",
            "fax_number": "909-793-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734608",
            "telephone_number": "909-793-3994",
            "fax_number": "909-793-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEY",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0234780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.