Mattax Neu Prater Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

94-7 Issued in MO

Legal business name

MATTAX NEU PRATER SURGERY CENTER, LLC

Practice address

1265 E Primrose St
Springfield, MO 65804-4278

Phone

(417) 886-3937

Fax

(417) 886-1285

NPI assigned

Mar 27, 2006

Last updated

May 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James B. Mattax Jr., MDNPI 1346244779

Title

President

Phone

(417) 886-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

Mattax Neu Prater Surgery Center LLCCCN 26C0001029

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Nasrazadani, MD

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1922529536
  Medicare reassignment NPD
• Jacob K. Thomas, MD

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1538328489
  Medicare reassignment NPD
• Drew Allen Young, MD

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1407411093
  Medicare reassignment NPD
• James B Mattax Jr., M.D.

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1346244779
  Authorized official Same address or phone
• Thomas G Prater, M.D.

  • Ophthalmology Physician
  • Springfield, MO
  • NPI 1043289119
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1386604908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "417-886-3937",
            "fax_number": "417-886-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E PRIMROSE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044278",
            "telephone_number": "417-886-3937",
            "fax_number": "417-886-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTAX NEU PRATER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "MATTAX",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-886-3937",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "94-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503156903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seth Matlock
• Megan Matney, NP-C
• Matt Stunkel DDS, LLC
• Mattax Neu Prater Eye Center, Inc
• Mattax Neu Prater Eye Center, Inc.
• James B Mattax Jr., M.D.
• Nancy G. Mattax, PH.D.
• Carol A Matthews, NP
• Jennifer Louise Mattox
• Curtis A Mattson, LP

• Ambulatory Surgical Clinic/Center in Springfield, MO
• Providers in Springfield, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.