Michael Todd Mathisen, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

818912 Issued in NV

Practice address

4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802

Phone

(702) 485-2100

Fax

(702) 902-2466

NPI assigned

Mar 20, 2019

Last updated

Mar 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Michael Todd Mathisen Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medtrans Behavioral Nevada Casal PLLCGroup PAC ID 7810259165, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medtrans Behavioral Nevada Casal, PLLC

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1245781160

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Alliance Mental Health Specialists Suba Park Cheng PLLC

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1275988107

  Single Specialty

  Medicare reassignment NPD
• Medtrans Medical Nevada Casal PLLC

  • Community Health Clinic/Center
  • Las Vegas, NV
  • NPI 1750846549

  Single Specialty

  Medicare reassignment NPD
• Homebase Care Casal PLLC

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1942863253
  NPD
• Medtrans Reno Casal PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Reno, NV
  • NPI 1699200808
  NPD
• I.C.a.N. Family Services LLC

  dba I.C.A.N. Family Services

  • Community/Behavioral Health Agency
  • Carson City, NV
  • NPI 1700385044
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1114487881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 ALMERTA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891788032",
            "telephone_number": "610-883-2862",
            "fax_number": "702-902-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE B6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-485-2100",
            "fax_number": "702-902-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHISEN",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "818912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "todd.mathisen@strategicbh.com",
            "affiliation": "N",
            "endpointDescription": "Office e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4270 S Decatur Blvd Ste B6",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891036802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "MATHISEN",
            "middle_name": "TODD",
            "prefix": "MR.",
            "credential": "APRN, PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Mae Mathis
• Michael Mathis
• Olivia Michelle Mathis, RN
• Shirley Mathis
• Tyesha Roshawn Mathis
• Argelia Mathues
• Darlene Mathyr, RN
• Sali S Mati
• Danica Matias
• John Bryan Matias

• Psychiatric/Mental Health Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.