Individual provider Active NPI

Julia A Mattson, M.D.

  • Obstetrics & Gynecology Physician
  • Fallston, MD
National Provider Identifier
1285603241
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0063050 Issued in MD
Practice address
1602 Angleside Rd
Fallston, MD 21047-1744
Phone
(410) 652-8310
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0063050 MD Primary

Addresses

Primary practice location

1602 Angleside Rd
Fallston, MD 21047-1744

Mailing address

1602 Angleside Rd
Fallston, MD 21047-1744
Phone (410) 652-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080828000547 DE Practitioner - Obstetrics/Gynecology 7214969583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0063050MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc Obstetrics & Gynecology CurrentSince Jul 14, 2008 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 14, 2008 Accepting new patients
Bay Life Services Corporation Past Accepting new patients

Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
Phone (302) 733-1700

4755 Ogletown Stanton Rd
Ste 1900
Newark, DE 19718
Phone (302) 733-6510

4755 Oglewtown Stant S 190
Newark, DE 19718
Phone (302) 733-6510

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1285603241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ANGLESIDE RD",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210471744",
            "telephone_number": "410-652-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ANGLESIDE RD",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210471744",
            "telephone_number": "410-652-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "JULIA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0063050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallston, MD

Sources for this page

Verify at the official NPI Registry.