Individual provider Active NPI

Christopher Michael Mattson, DO

  • Emergency Medicine Physician
  • Muskegon, MI
National Provider Identifier
1295229482
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101025510 Issued in MI
Practice address
1700 Clinton St
Muskegon, MI 49442-5502
Phone
(231) 726-3511
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 5101025510 MI Primary

Addresses

Primary practice location

1700 Clinton St
Muskegon, MI 49442-5502

Mailing address

1675 Leahy St Ste 315a
Muskegon, MI 49442-5543
Phone (231) 727-5244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210729003307 MI Practitioner - Emergency Medicine 1355744244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Mercy Campus
Muskegon, MI 49444-1849
Phone (231) 728-4601

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
  • Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Observation Services PLLC Single Specialty CurrentSince Sep 22, 2022 Accepting new patients
Lake Michigan Emergency Specialists, PLLC Single Specialty CurrentSince Jul 1, 2021 Accepting new patients

Locations

1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

Interoperability endpoints

  • Direct secure messaging: cmattson42784@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1295229482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-727-5244",
            "fax_number": "231-727-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CLINTON ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425502",
            "telephone_number": "231-726-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101025510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.