Individual provider Active NPI

Ann Isaac Mattamana, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1356638480
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD454089 Issued in PA
Practice address
833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone
(215) 955-5560
Fax
(215) 923-8219
NPI assigned
Jul 10, 2011
Last updated
Sep 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD454089 PA Primary
Psychiatry Physician 2084P0800X 2021017305 MO

Addresses

Primary practice location

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405

Mailing address

833 Chestnut St Ste 210
Philadelphia, PA 19107-4405
Phone (215) 955-5560

Other practice location 1

802 N Riverside Rd Ste 100B
Saint Joseph, MO 64507-2502
Phone (816) 271-8133

Other names 1

  • Ann Chandy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210910002451 MO Practitioner - Psychiatry 0840426458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

105 Far W Dr
202 Mosaic Life Care
Saint Joseph, MO 64506-3514
Phone (816) 271-8133

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center Current Accepting new patients
Heartland Regional Medical Center Psychiatry CurrentSince Sep 29, 2021 Accepting new patients
Heartland Regional Medical Center CurrentSince Sep 29, 2021 Accepting new patients
Heartland Regional Medical Center Past Accepting new patients

Locations

105 Far West Dr
Ste 202
Saint Joseph, MO 64506
Phone (816) 271-8133

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

802 N Riverside Rd
Ste 100B
Saint Joseph, MO 64507
Phone (816) 271-8133

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1395

Organizations & group practices 4

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 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": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1356638480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-5560",
            "fax_number": "215-923-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074405",
            "telephone_number": "215-955-5560",
            "fax_number": "215-923-8219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 N Riverside Rd Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645072502",
            "country_code": "US",
            "telephone_number": "816-271-8133",
            "fax_number": "816-271-8134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTAMANA",
        "first_name": "ANN",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-10",
        "last_updated": "2024-09-11",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD454089",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2021017305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "CHANDY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.