Individual provider Active NPI

Peter Joseph Mattingly, M.D.

  • Internal Medicine Physician
  • Fort Bragg, NC
National Provider Identifier
1306299813
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
295360 Issued in MA
Practice address
2817 Reilly St
Fort Bragg, NC 28310-7394
Phone
(910) 907-7697
NPI assigned
Jul 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021-00035 NC
Hospitalist Physician 208M00000X 295360 MA
Internal Medicine Physician 207R00000X 295360 MA Primary

Addresses

Primary practice location

2817 Reilly St
Fort Bragg, NC 28310-7394

Mailing address

2817 Reilly St
Fort Bragg, NC 28310-7394
Phone (910) 907-7697

Other practice location 1

41 Mall Rd
Burlington, MA 01805-7394
Phone (781) 744-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230228000859 MA Practitioner - HospitalistPractitioner - Internal Medicine 0547544918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Albany Medical College of Union University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295360MAMDInternal Medicine Physician
2021-00035NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Lahey Clinic Hospital, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Interoperability endpoints

  • Direct secure messaging: pmattingly197517@direct.bilh.masshiway.net

Organizations & group practices 3

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 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": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1306299813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107394",
            "telephone_number": "910-907-7697",
            "fax_number": "910-907-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107394",
            "telephone_number": "910-907-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018057394",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-20",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-00035",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "295360",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "295360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.