Chad Jeffrey Mattila, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4894 Issued in MN

Practice address

13743 85TH St NE
Otsego, MN 55330-6815

Phone

(763) 497-0899

Fax

(763) 592-8091

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northwest Spine and Pain Center of St. Michael, PA

  • Chiropractor
  • Saint Michael, MN
  • NPI 1609995877
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1306903299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13743 85TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306815",
            "telephone_number": "612-644-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13743 85TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306815",
            "telephone_number": "763-497-0899",
            "fax_number": "763-592-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTILA",
        "first_name": "CHAD",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-01-16",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1609995877",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Marie Manescalco, OD
• Sandra Louis Mangle, MA, LAMFT
• Nicole Martinson
• Mikki K Mason, LMFT, LADC
• Megan Cole Matteson, COTA/L
• Megan Louise McChesney, NP
• Medifit Health, LLC
• Christine Meierhofer
• Ann Clare Melde-Rahe, M.S, LPCC
• Marcus Piers Mensahn

• Chiropractor in Otsego, MN
• Providers in Otsego, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.