Individual provider Active NPI

John Qa Mattern, DO

  • Hospitalist Physician
  • Fishersville, VA
National Provider Identifier
1164495354
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0102201424 Issued in VA
Practice address
78 Medical Center Dr
Fishersville, VA 22939-2332
Phone
(540) 932-4075
Fax
(540) 932-5199
NPI assigned
Feb 9, 2006
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 0102201424 VA Primary

Addresses

Primary practice location

78 Medical Center Dr
Fishersville, VA 22939-2332

Mailing address

PO Box 388
Fishersville, VA 22939-0388
Phone (540) 932-4629

Other practice location 1

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-7580

Other identifiers 7

IdentifierTypeStateIssuer
210242OtherVASOUTHERN HEALTH
5748409OtherVACIGNA
5886945OtherVAVA PREMIER
005886945MedicaidVA
2202367OtherVAFIRST HEALTH
466150OtherVAANTHEM
64916OtherVAOPTIMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000354 VA Practitioner - HospitalistPractitioner - Internal Medicine 3870556053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta Medical GroupGroup PAC ID 3678632544, 409 clinicians

Practice addresses (Care Compare)

53 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 332-5687

78 Medical Ctr Dr
Fishersville, VA 22939-2332
Phone (540) 332-5595

9 S Medical Park Dr
Fishersville, VA 22939-2333
Phone (540) 245-7350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0102201424VAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Medical Group CurrentSince Oct 1, 2008 Accepting new patients
Augusta Medical Group CurrentSince Oct 1, 2008 Accepting new patients
Martha Jefferson Medical Group LLC Hospitalist CurrentSince Sep 13, 2021 Accepting new patients
Anesthesia Associates of Augusta, P.L.C. Past Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

53 S Medical Park Dr
Fishersville, VA 22939
Phone (540) 332-5687

78 Medical Center Dr
Fishersville, VA 22939
Phone (540) 245-7216

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14718/brand/4/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1164495354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229390388",
            "telephone_number": "540-932-4629",
            "fax_number": "540-932-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MEDICAL CENTER DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392332",
            "telephone_number": "540-932-4075",
            "fax_number": "540-932-5199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Martha Jefferson Dr",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229114668",
            "country_code": "US",
            "telephone_number": "434-654-7580",
            "fax_number": "434-654-7582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "JOHN",
        "middle_name": "QA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0102201424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "210242",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5748409",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "5886945",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005886945",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2202367",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "466150",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "64916",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

Verify at the official NPI Registry.