Active NPI
Eduardo Mattei, MD
- Otolaryngology Physician
- San Juan, PR
National Provider Identifier
1063447761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 4010
- Practice address
- 1801 Ave Ponce de Leon
Suite 301
San Juan, PR 00909-1900 - Phone
- (787) 727-3123
- Fax
- (787) 727-3163
- NPI assigned
- Jul 11, 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 4010 | PR | Primary |
Addresses
Primary practice location
1801 Ave Ponce de Leon
Suite 301
San Juan, PR 00909-1900
Mailing address
PO Box 9022
San Juan, PR 00908-0022
Phone (787) 727-3123
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 660368041 | Other | PR | TAX ID |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4010 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063447761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9022",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009080022",
"telephone_number": "787-727-3123",
"fax_number": "787-727-3163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 AVE PONCE DE LEON",
"address_2": "SUITE 301",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009091900",
"telephone_number": "787-727-3123",
"fax_number": "787-727-3163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTEI",
"first_name": "EDUARDO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "PR",
"license": "4010",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "660368041",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.