Zachary Mattson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13230 Issued in MN

Practice address

Regus Coworking Space 2355 Highway 36 West
Suite 400, Office #427
Roseville, MN 55113

Phone

(612) 418-1606

NPI assigned

Dec 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: zachary.mattson@811393367080964.direct.elationemr.com

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1396384376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REGUS COWORKING SPACE 2355 HIGHWAY 36 WEST",
            "address_2": "SUITE 400, OFFICE #427",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "612-418-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "ZACHARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Mason, M.A. L.P.
• Hassan Mohamed Fouad Masroujeh, DMD
• Cheryl Kay Matascastillo, L.M.F.T.
• Mary Mateffy
• Melvy S Mathew
• Scott Charles Mauch, M.D.
• Maxillofacial Imaging LLC
• Benjamin John May, M.D.
• Reza Mazhari, D.D.S.
• Logan McAbee-Thomas, LICSW

• Physician Assistant in Roseville, MN
• Providers in Roseville, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.