Individual provider Active NPI

Lora Mattia, NP-C

  • Adult Health Nurse Practitioner
  • Basking Ridge, NJ
National Provider Identifier
1205373412
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00701000 Issued in NJ
Practice address
30 Landau Rd
Basking Ridge, NJ 07920-3717
Phone
(732) 841-9338
NPI assigned
Jan 25, 2017
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00701000 NJ Primary
Gerontology Nurse Practitioner 363LG0600X 26NJ00701000 NJ

Addresses

Primary practice location

30 Landau Rd
Basking Ridge, NJ 07920-3717

Mailing address

30 Landau Rd
Basking Ridge, NJ 07920-3717
Phone (732) 841-9338

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170509000974 NJ Practitioner - Nurse Practitioner 7315224904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
51.39 of 100Reported as group
Quality
64.84
Promoting interoperability
0
Improvement activities
0
Cost
73.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00701000NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kane Wound Care LLC CurrentSince Apr 3, 2017 Accepting new patients

Locations

93 Manalapan Ave
Freehold, NJ 07728
Phone (732) 303-8800

919 Green Grove Rd
Neptune City, NJ 07753
Phone (732) 922-3400

100 Mazdabrook Rd
#One
Parsippany, NJ 07054
Phone (732) 841-9338

3626 US Highway 1
Princeton, NJ 08540
Phone (609) 243-0445

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1205373412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LANDAU RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203717",
            "telephone_number": "732-841-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LANDAU RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203717",
            "telephone_number": "732-841-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTIA",
        "first_name": "LORA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00701000",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00701000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

Verify at the official NPI Registry.