Individual provider Active NPI

George Ryan Mattes, D.C.

  • Chiropractor
  • West Palm Beach, FL
National Provider Identifier
1376098285
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11930 Issued in FL
Practice address
1551 Forum PL Ste 500C
West Palm Beach, FL 33401-2309
Phone
(561) 422-1819
Fax
(561) 422-1819
NPI assigned
Aug 20, 2016
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH11930 FL Primary

Addresses

Primary practice location

1551 Forum PL Ste 500C
West Palm Beach, FL 33401-2309

Mailing address

643 SW Lake Charles Cir
Port St Lucie, FL 34986-3428
Phone (772) 559-9141

Other practice location 1

2601 20th St
Vero Beach, FL 32960-6632
Phone (772) 299-4649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031000316 FL Practitioner - Chiropractic 6800174616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inn8 IncGroup PAC ID 4880961580, 3 clinicians

Practice addresses (Care Compare)

220 N Babcock St
Melbourne, FL 32935-6717
Phone (321) 327-7014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH11930FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
L. Lee Smith, D.C, P.a Chiropractor CurrentSince Oct 28, 2023 Accepting new patients
Inn8 Inc Chiropractor CurrentSince Oct 28, 2023 Accepting new patients
Bryan Wells, DC LLC PastSince Sep 27, 2016 Accepting new patients

Locations

220 N Babcock St
Melbourne, FL 32935
Phone (321) 254-5521

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.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1376098285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 SW LAKE CHARLES CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863428",
            "telephone_number": "772-559-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 FORUM PL STE 500C",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012309",
            "telephone_number": "561-422-1819",
            "fax_number": "561-422-1819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 20th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329606632",
            "country_code": "US",
            "telephone_number": "772-299-4649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTES",
        "first_name": "GEORGE",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-20",
        "last_updated": "2022-09-09",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.