Active NPI
Charles Mattina, M.D.
- Cardiovascular Disease Physician
- Eatontown, NJ
National Provider Identifier
1104890706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MA39801
- Practice address
- 11 Meridian Rd
Eatontown, NJ 07724-2242 - Phone
- (732) 663-0300
- Fax
- (732) 663-0301
- NPI assigned
- Feb 13, 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MA39801 | NJ | Primary |
Addresses
Primary practice location
11 Meridian Rd
Eatontown, NJ 07724-2242
Mailing address
11 Meridian Rd
Eatontown, NJ 07724-2242
Phone (732) 663-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0653403 | Medicaid | NJ |
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 |
|---|---|---|---|
| MA39801 | NJ | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monmouth Medical Electrocardiology | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Long Branch, NJ
- NPI 1487706891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458864000000",
"number": "1104890706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 MERIDIAN RD",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077242242",
"telephone_number": "732-663-0300",
"fax_number": "732-663-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 MERIDIAN RD",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077242242",
"telephone_number": "732-663-0300",
"fax_number": "732-663-0301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTINA",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2016-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NJ",
"license": "MA39801",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0653403",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eatontown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.