Individual provider Active NPI

Michelle Mattia, RDN

  • Registered Dietitian
  • Springfield, MA
National Provider Identifier
1114670502
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
175 Carew St
Springfield, MA 01104-2389
Phone
(413) 734-8254
NPI assigned
Jan 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

175 Carew St
Springfield, MA 01104-2389

Mailing address

74 Cambridge Cir
Longmeadow, MA 01106-2828
Phone (413) 218-3167

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419002846 MA Practitioner - Registered Dietitian Or Nutrition Professional 5890182992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

175 Carew St
Suite 200
Springfield, MA 01104-2391
Phone (413) 734-8254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5535MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Feb 14, 2022 Accepting new patients
Riverbend Medical Group, Inc. CurrentSince Feb 14, 2022 Accepting new patients
Mwa,PC Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

175 Carew St
Ste 200
Springfield, MA 01104
Phone (413) 734-8254

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1114670502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 CAMBRIDGE CIR",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011062828",
            "telephone_number": "413-218-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042389",
            "telephone_number": "413-734-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIA",
        "first_name": "MICHELLE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.