Active NPI
John T Mattson, MD
- Orthopaedic Surgery Physician
- Berkeley, CA
National Provider Identifier
1073545950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- G33079
- Practice address
- 3010 Colby St
118
Berkeley, CA 94705-2059 - Phone
- (800) 943-8099
- Fax
- (510) 845-0522
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | G33079 | CA | Primary |
Addresses
Primary practice location
3010 Colby St
118
Berkeley, CA 94705-2059
Mailing address
3010 Colby St
118
Berkeley, CA 94705-2059
Phone (800) 943-8099
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G33079 | Other | CA | BLUE CROSS |
| 00G330790 | Medicaid | CA | |
| 250007310 | Other | CA | RAILROAD MEDICARE PIN |
| G33079 | Other | CA | STATE LICENSE |
| 00G330790 | Other | CA | BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1073545950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 COLBY ST",
"address_2": "118",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052059",
"telephone_number": "800-943-8099",
"fax_number": "510-845-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 COLBY ST",
"address_2": "118",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052059",
"telephone_number": "800-943-8099",
"fax_number": "510-845-0522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTSON",
"first_name": "JOHN",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "G33079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "G33079",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G330790",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PIN",
"identifier": "250007310",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "G33079",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00G330790",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.