Mattison Angove, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

034422 Issued in NY

Practice address

1465 Foote Avenue Ext
Jamestown, NY 14701-9383

Phone

(716) 526-4041

NPI assigned

Sep 1, 2025

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mattison Wallin Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22211/brand/1/csg/1/fhir/r4
• Direct secure messaging: mattison.wallin.1@22211.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Chautauqua Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Dunkirk, NY
  • NPI 1760747521
  Medicare reassignment NPD
• Seneca Nation of Indians

  • Federally Qualified Health Center (FQHC)
  • Salamanca, NY
  • NPI 1023033511
  Medicare reassignment
• The Chautauqua Center, Inc

  • Gynecology Physician
  • Elmira, NY
  • NPI 1326817693
  NPD
• Jamestown Psychiatric PC

  • Child & Adolescent Psychiatry Physician
  • Jamestown, NY
  • NPI 1700062247
  NPD (past)
• Jamestown Psychiatric PC

  • Psychiatry Physician
  • Ridgway, PA
  • NPI 1003505132
  NPD (past)

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1255210480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 FOOTE AVENUE EXT",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019383",
            "telephone_number": "716-526-4041",
            "fax_number": "716-526-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 FOOTE AVENUE EXT",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019383",
            "telephone_number": "716-526-4041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Thomas Indian School Dr",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "NY",
            "postal_code": "140819341",
            "country_code": "US",
            "telephone_number": "716-532-5582",
            "fax_number": "716-242-6344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "987 R C Hoag Dr",
            "address_purpose": "LOCATION",
            "city": "Salamanca",
            "state": "NY",
            "postal_code": "147791365",
            "country_code": "US",
            "telephone_number": "716-945-5894",
            "fax_number": "716-242-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGOVE",
        "first_name": "MATTISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-01",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTISON",
            "last_name": "WALLIN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Anderson
• Sandra Lee Anderson, MASSAGE THERAPIST
• Valerie Katherine Anderson, RN
• Amanda Catherine Andrews, MS, LMHC
• Olivia Andriaccio, NP
• Anthony J Peppy & Samuel J Peppy DDS PC
• Frank Arnal
• Debra Lynn Arndt, CNM
• Eric David Arnone, M.D.
• Arthur Laury Opticians

• Physician Assistant in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.