Nancy Lynn Mattoni, NURSE PRACTIONER
Individual provider Active NPI Nurse Practitioner · Rochester Hills, MI
NPI 1316020902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316020902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704109576 (MI)
- Practice address
- 332 W Tienken Rd
Suite B
Rochester Hills, MI 48306-4473 - Phone
- (248) 656-1300
- Fax
- (248) 656-7459
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Health Rochester Hospital
Practice addresses (Care Compare)
1135 W University Dr
Suite 355
Rochester, MI 48307-1871
Phone (248) 652-6640
Hospital & facility affiliations
- Ascension Providence Rochester Hospital
- Henry Ford Health St John Hospital
- Beaumont Hospital, Troy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110617000415 | MI | Practitioner - Nurse Practitioner | 0446438600 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704109576 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Rochester Hospital | Current | Accepting new patients | |
| Henry Ford Health Rochester Hospital | Nurse Practitioner | Current |
Accepting new patients |
| Henry Ford Health Rochester Hospital | Nurse Practitioner | Current |
Accepting new patients |
| Henry Ford Health Rochester Hospital | Current |
Accepting new patients |
Locations
1135 W University Dr
Ste 355
Rochester Hills, MI 48307
Phone (248) 680-8060
1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805
Interoperability endpoints
- nmattoni1140572@direct.hfhs.org
- https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704109576 | MI | Yes |
Addresses
Primary practice location
332 W Tienken Rd
Suite B
Rochester Hills, MI 48306-4473
Mailing address
332 W Tienken Rd
Suite B
Rochester Hills, MI 48306-4473
Phone (248) 656-1300
Other providers in Rochester Hills, MI
- Julie G Masters
- Lucynda Angelina Matchett
- Joseph Matievich
- Matthew Z. Fox D.M.D., P.C.
- Anissa R Mattison
- Jennifer Lynne Matyn
- Noelle Marie Maude
- Ami K Mavani
- Alexandra B Maxwell
- Alexandra May
All providers in Rochester Hills, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.