Mallory Matheson

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5900 Lake Wright Dr
Norfolk, VA 23502-1871

Phone

(757) 466-8683

NPI assigned

Mar 20, 2020

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Education

Eastern Virginia Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.matheson@voa.ikm.direct-ci.com
• Direct secure messaging: mallory.matheson.1@9109.direct.athenahealth.com

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.

• North Florida Surgeons, PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1912953290
  Medicare reassignment Care Compare group NPD
• North Florida Surgeons, PA

  dba NFS Florida Bone and Joint

  • Orthopaedic Surgery Physician
  • Gulf Breeze, FL
  • NPI 1871442053
  NPD

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1235765306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 LAKE WRIGHT DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021871",
            "telephone_number": "757-466-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 LAKE WRIGHT DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021871",
            "telephone_number": "757-466-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "MALLORY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory J Massimi, MD
• Grayson Mast
• Robert Jay Masters, FNP
• Stefani Masterton, ATC
• Ramon A Matawaran, MD
• Supriya Susan Mathew, CSW
• Aaron Mathews
• Anjuli E Mathews, CSA
• Cara Mathews, LCSW
• Erin M Mathews, OTR/L

• Physician Assistant in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2020; 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.