Individual provider Active NPI

Christina Ruthann Mattes, APRN

  • Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1316719685
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11029414 Issued in FL
Practice address
1301 W Eau Gallie Blvd Ste 108
Melbourne, FL 32935-5390
Phone
(321) 622-8730
NPI assigned
Oct 30, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11029414 FL Primary

Addresses

Primary practice location

1301 W Eau Gallie Blvd Ste 108
Melbourne, FL 32935-5390

Mailing address

PO Box 361095
Melbourne, FL 32936-1095
Phone (321) 622-8730

Other names 1

  • Miss Christina Ruthann Corripio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114003781 FL Practitioner - Nurse Practitioner 4688021561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians
Brevard Primary Care LLCGroup PAC ID 1153541669, 4 clinicians

Practice addresses (Care Compare)

111 E Hibiscus Blvd
Melbourne, FL 32901-3102
Phone (321) 768-3655

2328 Citadel Way
Suite 103 319
Melbourne, FL 32940-6459
Phone (321) 757-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
70.52
Promoting interoperability
100
Improvement activities
40
Cost
73.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11029414FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC CurrentSince Jan 8, 2024 Accepting new patients
Brevard Primary Care LLC CurrentSince Apr 1, 2025 Accepting new patients
Florida Kidney Physicians, LLC CurrentSince Jan 8, 2024 Accepting new patients

Locations

1150 N 35th Ave
Ste 620
Hollywood, FL 33021
Phone (954) 612-8173

111 E Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 725-8919

14 Suntree Pl
Ste 104
Melbourne, FL 32940
Phone (321) 768-3655

2328 Citadel Way
Ste 103319
Melbourne, FL 32940
Phone (321) 757-1900

19056 NE 29th Ave
Miami, FL 33180
Phone (305) 354-4558

450 Malabar Rd SE
Palm Bay, FL 32907
Phone (321) 752-3888

450 Malabar Rd SE
Unit 102
Palm Bay, FL 32907
Phone (321) 435-3655

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: christina.mattes.1@15644.direct.athenahealth.com
  • Direct secure messaging: cmattes71814@epicdirect.hf.org
  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1316719685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361095",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361095",
            "telephone_number": "321-622-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 108",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355390",
            "telephone_number": "321-622-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTES",
        "first_name": "CHRISTINA",
        "middle_name": "RUTHANN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11029414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "CORRIPIO",
            "middle_name": "RUTHANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.