Mary E. Matzeder, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

882 Issued in KS

Practice address

20705 W 151St St
Olathe, KS 66061-7222

Phone

(913) 972-5179

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, CO, IL, NC, TX, DE6 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 6

Specialty

Clinical Psychologist

Education

University of Kansas School of Med (KC/Wich/Sal), 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Brightside Medical, P.a.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1609335660

  CO, IL

  Medicare reassignment

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1184777872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 TOMASHAW ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191571",
            "telephone_number": "913-972-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20705 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617222",
            "telephone_number": "913-972-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATZEDER",
        "first_name": "MARY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "R0380",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200441610A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael W Mathews, M.D.
• Emily Suzanne Mathiesen, M.D.
• Jessica Lynn Mathis, LPC
• Stephanie Ann Matile
• Jodi Matz, RD, NBC-HWC
• Elizabeth Cloie Mauldin
• Jolena Kay Mauldin, LCP
• Shelby Maurer, OTA
• Michael Maxson
• Rebecca May, MA-CCC-SLP

• Psychologist in Olathe, KS
• Providers in Olathe, KS by specialty
• Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; 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.