Individual provider Active NPI

Danielle Mattar, RPH

  • Pharmacist
  • Dedham, MA
National Provider Identifier
1396333795
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24471 Issued in MA
Practice address
160 Providence Hwy
Dedham, MA 02026-1809
Phone
(781) 320-1574
NPI assigned
Jan 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24471 MA Primary

Addresses

Primary practice location

160 Providence Hwy
Dedham, MA 02026-1809

Mailing address

160 Boylston St Apt 2459
Chestnut Hill, MA 02467-2018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
24471MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Biocardia Diagnostics Current Accepting new patients
Biocardia Diagnostics Inc Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1396333795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BOYLSTON ST APT 2459",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PROVIDENCE HWY",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020261809",
            "telephone_number": "781-320-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTAR",
        "first_name": "DANIELLE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-02",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "24471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.