Individual provider Active NPI

Sean R Mattingly, FNP

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1245879980
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R215838 Issued in MD
Practice address
501 W 7TH St
Frederick, MD 21701-4586
Phone
(301) 698-8375
NPI assigned
Dec 28, 2019
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R215838 MD Primary

Addresses

Primary practice location

501 W 7TH St
Frederick, MD 21701-4586

Mailing address

501 W 7TH St
Frederick, MD 21701-4586
Phone (301) 698-8375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200309000039 MD Practitioner - Nurse Practitioner 5890123731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1194 Dutchmans Creek Dr
Unit 3
Brunswick, MD 21716-9787
Phone (240) 215-6310

16403 Old Emmitsburg Rd
Emmitsburg, MD 21727-8929
Phone (240) 215-6310

3430 Worthington Blvd
Frederick, MD 21704-7017
Phone (240) 215-6310

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 215-6310

501 W 7TH St
Suite 104
Frederick, MD 21701-5096
Phone (240) 215-6310

504 E Ridgeville Blvd
Mount Airy, MD 21771-5942
Phone (240) 215-6310

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R215838MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC CurrentSince Jun 3, 2020 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Jun 3, 2020 Accepting new patients
Frederick Health Medical Group LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

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 1

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": "1577491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1245879980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014586",
            "telephone_number": "301-698-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014586",
            "telephone_number": "301-698-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "SEAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-28",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R215838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.