Lisa Susan Mattam, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

E-9356 Issued in AR

Practice address

521 Ranch Rd
Weston, FL 33326-1757

Phone

(305) 799-2248

NPI assigned

Apr 19, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastside Hospitalists IncGroup PAC ID 9436157831, 179 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmattam173682@mhsdirect.net

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.

• Eastside Hospitalists Inc

  • Hospitalist Physician
  • Hollywood, FL
  • NPI 1285676957
  Medicare reassignment Care Compare group NPD
• QMC LLC

  • Hospitalist Physician
  • Miami, FL
  • NPI 1003216391
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1407290554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 RANCH RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 RANCH RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261757",
            "telephone_number": "305-799-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTAM",
        "first_name": "LISA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-9356",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-9356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmattam173682@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brielle Maser, PA-C
• Helen Mashburn, BCBA
• Maria Milagros Masson Neumann
• Hannah Mathew, PT, DPT
• Jason Z Mathew, PHARM.D
• Megan Matthews
• Tia Lanaye Mattox, OTR/L
• Natalia Matute
• Maximus Medical Supplies LLC
• Maxine a. Sadhai, Psy.D. & Associates, P.a.

• Hospitalist Physician in Weston, FL
• Providers in Weston, FL by specialty
• Hospitalist Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.