Active NPI
Vickie E Mata
- Case Manager/Care Coordinator
- Lynn, MA
National Provider Identifier
1285199539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 100 Willow St
Lynn, MA 01901-1139 - Phone
- (781) 581-6600
- Fax
- (781) 581-2209
- NPI assigned
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | MA | Primary |
Addresses
Primary practice location
100 Willow St
Lynn, MA 01901-1139
Mailing address
100 Willow St
Lynn, MA 01901-1139
Phone (781) 581-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1171M00000X | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lynn Shelter Association | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Case Management Agency
- Lynn, MA
- NPI 1619425196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1285199539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WILLOW ST",
"city": "LYNN",
"state": "MA",
"postal_code": "019011139",
"telephone_number": "781-581-6600",
"fax_number": "781-581-2209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WILLOW ST",
"city": "LYNN",
"state": "MA",
"postal_code": "019011139",
"telephone_number": "781-581-6600",
"fax_number": "781-581-2209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "VICKIE",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-31",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1171M00000X",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.